Background to this inspection
Updated
19 March 2018
Her Majesty’s Prison Exeter is a category B local prison that accepts all adult and young offenders committed to prison by the courts in Devon, Cornwall, Somerset and further afield. Ark Home Healthcare Ltd provides social care services to prisoners, comparable to those found in the wider community. The location, Ark Home Care Brixham is registered to provide the regulated activity personal care. CQC and Her Majesty’s Inspectorate of Prisons (HMIP) undertake joint inspections under a memorandum of understanding. Further information on this and the joint methodology can be found by accessing the following website: http://www.cqc.org.uk/content/health-and-care-criminal-justice-system.
CQC inspected this service with HMIP in August 2016, at that time Ark Home Healthcare Ltd were registered to provide personal care to prisoners. We found evidence that essential standards were not being met and one Requirement Notice was issued in relation to Regulation 18 Staffing, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This report can be found by accessing the following website: https://www.justiceinspectorates.gov.uk/hmiprisons/inspections/hmp-exeter/.
Updated
19 March 2018
ARK Home Healthcare Ltd provides care and support to mostly older people, who live in their own homes. The services provided include personal care and domestic work in Brixham, Paignton and Torquay.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
We visited the office on 4 November 2015. At the time of this announced inspection 190 people were using the service. At the previous inspection in February 2014, the service did not meet the regulation in relation to respecting and involving people. People were not satisfied with their visit schedules and communication with the service’s customer response centre, which was based in Sheffield. The provider sent us an action plan telling us what they were going to do to meet the regulation. At this inspection in November 2015 we checked and found improvements had been made.
People and their relatives were positive about the way staff treated them. Each person we spoke with told us their care workers were kind and compassionate. Comments included “The carers I get have eased my worries about who looks after me. They are really nice”; “I appreciate the company they give me, we sit down with a cup of tea and have a chat”; and “They smile, talk, that’s what you want when you’ve been ill” and “They’re very very nice indeed”. The service had received compliments from people and their relatives thanking the staff for their care and kindness. We spoke with a person who told us “I am giving the staff a party on my Birthday, to say thank you to ARK. I’m so pleased you rang so I could tell you how happy I am”. People were happy and relaxed when we visited them in their homes. Staff treated people with respect and kindness. People responded to this by smiling and engaging with staff in a friendly way.
People told us the service was reliable and staff were usually on time. Comments included “They arrive when they’re meant to”; “They’re on time, give or take five or ten minutes”; “ If they are running late they usually ring up” and “sometimes they have a problem at their previous visit”. People told us staff never rushed them. One person commented “They always stay the time even if they are running late. They have to toilet and shower me and I’m never rushed”. Staff told us they had enough time to travel between visits. Staff said “All my calls are close together” and “When I’ve had issues at a call, the office have helped me out and got someone else to cover my next visit”.
People and their relatives told us they felt safe when they received care. People told us“ There’s no reason not to feel safe” and “They always wear their pink tunics so I know it’s them when they arrive. I can see them coming through my window” and “ I’m absolutely fine. I’ve had them coming round for years and I know them all”. Some people had key safes installed outside of their homes. This meant staff were able to access people’s homes when they were unable to open their doors.
People had a regular team of staff who had the appropriate skills to meet their needs. Comments included “ I’ve been with the service for two years now and I usually get the same carers who know how to look after me”;“ I think the carers are very skilled in helping us get through this, they always listen”; “I’m very happy with what they’re doing”, and “They’re absolutely marvellous”.
Staff knew people well and were able to tell us how they supported people. During a home visit, we saw staff had developed a warm and engaging relationship with the person. Staff clearly knew the person well and interacted with the person in a friendly yet respectful manner. The person was happy and relaxed in the company of the staff who were supporting them. Staff explained what they were doing and ensured the person was comfortable. One staff member knew how the person liked to have their pillows arranged in a certain way and made sure other staff knew about this. Staff talked about their planned outing that day and the person visibly brightened at the thought of going out.
Safe staff recruitment procedures were in place. This helped reduce the risk of the provider employing a person who may be a risk to vulnerable people. People were protected by staff who had completed safeguarding training and knew what to do if they were concerned that a person was being abused.
Risk assessments had been undertaken. These included information about action to be taken to minimise the chance of harm occurring to people and staff. Where people were supported to have their medicines this was done safely. People had received their medicines as they had been prescribed by their doctor to promote good health.
The registered manager was working towards the Level 5 Diploma in Leadership and management. Staff told us the registered manager was approachable. Comments included “(Registered manager’s name) is approachable no matter what the issue is” and “When I sent a message they replied instantly”. A healthcare professional told us the registered manager was very approachable. They said the registered manager and seniors had come out and done joint visits with them when needed which was really useful.
People and their relatives felt able to raise concerns or make a complaint if the need arose. Comments included “Any problems, I go and see them. They’re pretty good at sorting things out” and “I haven’t had any problems”. The service had received three complaints in the past year. Each complaint had been investigated and responded to in line with the complaints procedure.
There were systems in place to assess, monitor, and improve the quality and safety of care. The provider had carried out an audit in September 2015. They looked at care plans and staff files. Some staff files had information missing. The registered manager had since given one of the office staff responsibility to ensure files contained all of the relevant information. A quality assurance survey was sent to people in April 2015. The service received 84 responses. The survey showed 98% of people were ‘very happy’ or ‘happy’ with the service. The service had identified areas to focus on to improve the service. For example, in relation to offering people choices. A newsletter had been sent out to staff which include information about choices and their practice was monitored. The registered manager told us they attended the provider’s management meetings every four weeks. This gave them the opportunity to meet up with other registered managers, receive updates and share good practice. They also accessed resources to learn about research and current best practice.