Hanover Care Limited

Updated 27 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 13 February 2018 and was announced. We told the registered manager a week before our inspection that we would be coming. This was because we wanted to make sure that the registered manager and other appropriate staff were available to speak with us on the day of our inspection. Two inspectors undertook the inspection, with an expert-by-experience, who had experience of older people’s care services. The expert by experience helped us with the telephone calls to get feedback from people being supported.

We previously carried out a comprehensive inspection on 9 November 2015 when the service was rated Good overall.

The provider was not asked to complete a Provider Information Return (PIR) on this occasion. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at other information we held about the service. This included previous inspection reports and notifications. Notifications are changes, events or incidents that the service must inform us about. We contacted and received feedback from the local authority commissioning team about their experiences of the service provided. We contacted six health and social care professionals for feedback on the service provided and received one response. We spoke with 11 people who used the service and a relative.

During the inspection we went to the service’s office and spoke with the registered manager, a care co-ordinator, a home care consultant and three care staff. We spent time looking at records, including eight people’s care records, six staff files including recruitment documentation and other records relating to the management of the service, such as policies and procedures, compliments and complaints records, accident/incident recording and audit documentation. We also ‘pathway tracked’ the care for some people using the service. This is where we check that the care detailed in individual plans matches the experience of the person receiving care. It was an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.

Updated 27 March 2018

The inspection took place on 13 February 2018.

Hanover Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults, but predominantly to older adults, including people who may have a physical disability, a learning disability, sensory loss, mental health problems or people living with dementia living in Brighton and Hove. At the time of our inspection around 45 people were receiving a service, not all of whom were receiving the regulated activity of personal care.

At the last inspection on 9 November 2015 the service was rated overall Good. At this inspection we found the service remained overall Good. At the last inspection we found robust systems were not in place for reviewing, monitoring and assessing the delivery of care and support. The provider was not undertaking their own internal audits, therefore they were unable to demonstrate how they monitored and identified where standards were falling. At this inspection we found significant improvements had been made, however there were still areas in relation to the quality assurance process in need of being addressed and embedded into the practice.

Systems had been maintained to keep people safe. People told us they felt safe with the care provided. One person told us, “The carers have a friendly but professional manner and that gives me confidence and makes me feel safe.” Another person told us, “Having a regular carer makes me feel safe.” A third person said,” The carers have a friendly but professional manner and that gives me confidence and makes me feel safe. I know they are there in the background.” They felt they could raise concerns and they would be listened to. People remained protected from the risk of abuse because staff understood how to identify and report it. Assessments of risks to people had been developed. Staff told us they had continued to receive supervision, and be supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. People told us care staff had the knowledge and skills to provide their care and support. One member of staff told us, “Training is kept up to date. We are told in advance we have to do it and have to submit answers to show we have understood. They tell us of additional training that can be available and they invite us to apply if we want. I see someone with Parkinson’s and was able to have some training about it.”

People's individual care and support needs continued to be identified before they received a service. Care and support provided was personalised and based on the identified needs of each person. People told us they felt listened to, supported to be independent and they were involved in decisions about their care. Staff had an understanding of consent. A relative told us, “I have been delighted that the carers are able to manage my relative’s condition. They know how to manage her moods and keep her happy. They always take care to tell (Person’s name) what they are doing. They never take her by surprise.”

People were happy with the care provided. Comments from people included, “This agency is better than any I’ve seen and between my wife and I we’ve seen a lot,” “They come out trumps,” “I am perfectly happy with the care that I get,” and “I would whole heartedly recommend them, no hesitation.”

People continued to be supported by kind and caring staff who treated them with respect and dignity. A relative told us, “My wife had different carers and if they crossed over, the carers were very respectful and they always included my wife in our conversations which I thought was good as we were all in it together.” They were spoken with and supported in a sensitive, respectful and professional manner. One person told us, “I was recently bereaved and my carer came to the funeral and it has helped to be able to talk to her about my loss. The agency also phoned and sent a card, it was appreciated and very thoughtful. They have since checked to see if I need to increase the care but at the moment my family are doing a bit more. I won’t hesitate to call them if I need to up things.”

People and staff told us the service continued to be well led. One person told us, “I would whole heartedly recommend them no hesitation.” One member of staff told us, “I feel the management cares, and gives a lead on how we all care about the people we visit. If somebody dies, they let us all know. They support people’s families with difficulties. We get informed quickly about issues that arise through every day care, say someone’s mobility needs have changed. If we are on a short call but find someone upset, we stay longer and the office will adjust visits and keep people informed. You can say anything to management and know they will respect and support you, so you aren’t afraid to raise anything.” Senior staff carried out a range of internal audits, and records confirmed this. People and their relatives were regularly consulted about the care provided through reviews and by using quality assurance questionnaires.