Archived: HICA Home Care - Hull

Updated 7 May 2016

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 registered provider was 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 unannounced inspection took place on 5 and 6 April 2016 and was carried out by an adult social care inspector.

We asked the registered provider to complete a Provider Information Return (PIR) before the inspection was undertaken. A PIR is a form that is completed by the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We also looked at the notifications received and reviewed all the intelligence CQC held to help inform us about the level of risk for this service.

We spoke to the local authority commissioning and safeguarding teams to gain their views on the service. During our discussions they told us they had no concerns regarding the service.

During the inspection we spoke with 12 people who used the service and one relative. We also spoke with the registered manager, the operations director, the quality assurance manager, the deputy manager, the service manager, the training manager and eight members of staff.

We looked at six people’s care plans along with the associated risk assessments and Medicines Administration Records (MARs). We also looked at how the service used the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) to ensure that when people were assessed as lacking capacity to make informed decisions themselves or when they were deprived of their liberty, actions were taken in their best interest.

We looked at a selection of documentation pertaining to the management and running of the service. This included quality assurance information, action plans, stakeholder surveys, recruitment information for six members of staff, the staff training records as well as the registered provider’s policies and procedures.

Updated 7 May 2016

HICA Care Home – Hull is registered to provide people with care and support in their own home. At the time of the inspection a manager was in place. 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 carried out an unannounced comprehensive re-rating inspection of this service on 5 and 6 April 2016. This was to check that the registered provider now met legal requirements we had identified at inspections in December 2014 and October 2015.

Following our comprehensive inspection in October 2015 the registered provider was found to be non-compliant with regulations pertaining to providing safe care and treatment. During this re-rating comprehensive inspection we saw that the registered provider had taken appropriate action to ensure people were cared safely and that medicines were managed effectively.

Following our comprehensive in October 2015 the registered provider was found to be non-compliant with regulations pertaining to assessing and monitoring the quality of service provision. During this re-rating comprehensive inspection we saw that the registered provider had taken appropriate action; an internal review of the service’s day to day management and had taken action to ensure shortfalls in care and support would be identified in a timely way which enabled action to be taken promptly. Action plans to improve the service included realistic timescales and were monitored effectively to the completion. The internal review completed by the registered highlighted other areas that required improvements such as providing refresher training to staff and ensuring internal policies and procedures were reviewed at appropriate intervals and in line with current best practice and legislation.

Following our comprehensive in October 2015 the registered provider was found to be non-compliant with regulations pertaining to safeguarding vulnerable adults from abuse and improper treatment. During this re-rating comprehensive inspection we saw that the registered provider had taken appropriate action to ensure staff responded appropriately in emergency situations. Missed calls had reduced and a new call monitoring system had been implemented which highlighted when a call had not been attended at the allocated time. The service took action when staff’s action fell below expectable standards.

During the inspection we saw improvements had been made and have changed the rating for the ‘safe’ and ‘well-led’ domain from inadequate to requires improvement. However, we could not rate the service higher than requires improvement for ‘effective’, ‘caring’ and ‘responsive’ because to do so requires consistent and sustained improvement over time.

Staff received appropriate supervision and support from their line manager; they had completed relevant training and understood how to meet the needs of the people they supported. However, records showed staff did not receive refresher training in a number of areas which meant staff did not always have up to date skills and knowledge in relevant areas, such as fire safety, first aid, food hygiene and infection control. The registered provider’s training manager informed us that action was being taken to rectify this and staff would receive annual refreshers to meet their training needs. Some staff had not received an annual appraisal and we mentioned this to the registered manager. They acknowledged the issue and informed us that all outstanding annual appraisals would be completed by the end of April 2016.

This meant that the service was in breach of regulation 18 of the Health and Social Care Act 2008 [Regulated Activities] Regulations 2014. You can see a summary of the actions we have asked the registered provider to take at the back of the full version of this report.

Suitable numbers of staff who had been recruited safely were employed to meet the needs of the people who used the service. Risks identified during people’s initial assessment and on-going reviews were managed to mitigate the possibility of their occurrence.

Consent was gained before care and support was delivered and the principles of the Mental Capacity Act were followed. People we spoke with told us they consented to the care and support they received. People were supported to eat a diet of their choosing and staff encouraged people to eat healthily. When concerns were identified relevant professionals were contacted for their advice and guidance.

People told us they were supported by kind and caring staff who knew their preferences for how care and support should be delivered. People told us staff respected their privacy and dignity. Private and sensitive information was treated confidentially by staff who understood their responsibilities not to disclose it outside of the service.

People were involved with the initial and on-going planning of their care. Their levels of independence and individual abilities were recorded. The registered provider had a complaints policy which was made available to people who used the service. When complaints were received they were investigated in line with the policy and used to develop the service when possible.