Honest Home Care

Updated 15 October 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service short notice of the inspection. This was because we needed to give them time to prepare for our visit due to the COVID-19 pandemic.

Inspection activity started on 16 September 2021 and ended on 28 September 2021. We visited the office location on 22 September 2021.

What we did before the inspection

We reviewed information we had received about the service since registration. We sought feedback from the local authority. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with five people who used the service and eight relatives of people who used the service, about their experience of the care provided. During our visit to the office we spoke with the registered manager and the provider. We spoke with four members of staff. We reviewed a range of records. These included three people’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek any clarification we needed in relation to records we had reviewed.

Updated 15 October 2021

About the service

Honest Home Care is a domiciliary care agency which means staff go into people’s own homes to provide care and support. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection there were 51 people using the service.

People’s experience of using this service and what we found

The management team completed regular checks to monitor the quality and safety of services provided. However, these checks were not always robust. The service had not reported all safeguarding incidents to CQC and there were shortfalls with record keeping, which were not identified by the management team before we came to inspect. Despite these findings, people told us they received a good service overall and staff spoke highly of the management team. The registered manager was open about the challenges of being a new service during the COVID-19 pandemic and welcomed all CQC feedback.

People who used the service said they received a safe service from Honest Home Care and no one reported issues around missed care visits. There was, however, a recurring theme about staff being late to planned care visits. The provider acknowledged this was a problem and had already embarked on plans to robustly address this before we came to inspect.

People told us they received their medicines in line with the prescriber’s instructions. We made a recommendation about how staff record when they have administered or supported a person to take their medication.

Staff underwent recruitment checks before they were able to work at Honest Home Care, however, there were three occasions where not all recruitment checks had been recorded. We found no evidence this impacted on people who used the service and the registered manager took immediate action to address our concerns.

Risks were appropriately assessed, which then lead to assessments being put into place to guide staff on how to keep people safe. We feedback that risk assessments would benefit from more detail, which the registered manager agreed to address. Staff used personal protective equipment (PPE) appropriately when supporting people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and promoted independence; the policies and systems in the service supported this practice.

Staff received induction training and followed a programme of continuous learning. Staff said they felt well supported. People’s needs were assessed, and care and support was reviewed as their needs changed. Appropriate referrals were made to external services to ensure people’s needs were met.

Feedback we received from people who used the service and their relatives was complimentary about the care staff. Staff involved people in decisions about their day to day care and consulted people regarding what they wanted.

Systems were in place to make sure the service complied with the Accessible Information Standards.

People’s care records documented the level of care and support required. We made a recommendation about how the service recorded care reviews, to better illustrate what decisions had been made about people’s care, with reference to discussions with people and their representatives. Complaints were investigated and responded to appropriately.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

This service was registered with us on 05/05/2020 and this is the first inspection

Why we inspected:

This was the first inspection of a newly registered service.

Enforcement:

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the provider’s systems of governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up:

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.