Background to this inspection
Updated
28 June 2019
Background to this 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
This inspection was carried out by one adult social care inspector.
Service and service type:
Harbex Nursing and Care is a domiciliary care agency. It provides personal care to people living in their own homes. Not everyone using Harbex Nursing and Care Services received a regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; such as assistance with washing and dressing or preparing meals. help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection, 53 people were receiving personal care.
The service had a manager, but they had not yet registered with the Care Quality Commission. The manager had recently been appointed following the resignation of the previous registered manager in February 2019. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The new manager told us that she was in the process of applying for registration.
Notice of inspection:
We gave the service 24 hours’ notice of the inspection visit because it is small, and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be available on the days of our inspection.
Inspection site visit activity started on 14 May 2019 and ended on 15 May 2019. We visited the office location on both days to see the manager and to review care records and policies and procedures. We visited five people in their own homes on the second day of our inspection.
What we did:
We reviewed information we had received about the service, this included details about incidents the provider must notify us about, such as abuse or injuries; and we sought feedback from the local authority and other professionals who work with the service. We contacted the local authority safeguarding and commissioning teams to gather information about the service. They raised no concerns about the care and support people received from Harbex Nursing and Care Services. We used all this information to plan our inspection.
During our inspection we spoke with four members of care staff, the manager, compliance and quality manager and service provider, five people using the service, and three relatives. We reviewed six care files, four staff personnel files, medicine administration records and other records about the management of the service.
Updated
28 June 2019
About the service:
Harbex Nursing and Care is a domiciliary care agency. At the time of our inspection the service was providing care and support to 53 people living in their own homes. The service did not provide any nursing care.
People’s experience of using this service:
Staff were aware of risks to people’s security and took steps to ensure their safety. They demonstrated a good understanding of safeguarding policy and procedures and were vigilant to any signs of abuse. Where risk to people’s health, safety and wellbeing had been identified care plans were put in place to manage these risks. Care plans were person-centred and generally provided staff with the information they needed to provide care and support in a way that met people’s needs and preferences. However, we found one care plan did not indicate the person’s current needs.
There were enough care staff to meet the needs of people and deliver a consistent service. When taking on new staff the service ensured appropriate checks were carried out to check candidates’ suitability to work with vulnerable people. Ongoing training provided staff with up to date knowledge and understanding of their care and support responsibilities.
Medicines were appropriately managed for people who needed assistance with medicines. Clear records of any creams applied, and medicines administered were monitored and kept up to date.
People said the staff were well trained, understood them and knew how to meet their needs in a person-centred way. One person told us, “[The staff] all know what to do and how to do it.” All staff had access to supervision and their performance was regularly monitored.
People told us that they were supported by staff who knew them well. Visits were allocated in zones which reduced the travel time for staff and meant people were supported by small and consistent staff teams.
When we asked them, people supported by Harbex Nursing and Care said that the care staff were kind, caring and cheerful. They confirmed staff sought their consent before undertaking any care task or entering their home and that they would always offer choices around how their care was provided. They told us that the care staff had enough time to perform tasks and would spend time listening to what they had to say. Privacy and choice were respected, and confidential information was kept securely.
The people we spoke with were aware of how to complain and told us that when they had made complaints these resulted in improvements in their support. We saw complaints were taken seriously with full consideration and appropriate investigation.
There were processes in place to monitor the safety and quality of the service. The manager and provider undertook quality assurance monitoring of the service and any actions arising from this had been addressed.
People were given opportunities to provide feedback on the quality of their support and given the opportunity to comment on the service they received. Surveys and questionnaires showed a high level of satisfaction. Analysis of trends showed an increase in satisfaction levels since the previous year.
Services like Harbex Nursing and Care are required to have a manager who is registered with the Care Quality Commission (CQC). A new manager had been appointed to the service at the end of February 2019, but had not yet completed the registration process. The manager in post was supported in the day to day management of the service by the provider, compliance and quality manager and recently appointed key workers. The management team were open and supportive to staff and understood their responsibilities to operate the service safely and effectively.
Rating at last inspection:
At our last inspection, the service was rated “Requires Improvement’”. Our last report was published on 23 May 2018 and recorded multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected:
This was a planned inspection. Our announced inspection started on 14 May 2019 and ended on 15 May 2019.
Follow up:
Going forward we will continue to monitor this service and plan to inspect in line with our re-inspection schedule for services rated Good.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk