Archived: Hales Group Limited - Lowestoft

Updated 4 October 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 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 18 and 28 July 2016, and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service, and we needed to be sure that someone would be available on our arrival. The inspection was undertaken by two inspectors 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.

Before our inspection the provider completed a Provider Information Return (PIR). 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 reviewed information we held about the service, such as notifications and information sent to us from other stakeholders for example the local authority and members of the public.

We spoke with 18 people who used the service and seven relatives. We spoke with the registered manager, quality assurance officer, and six care workers. We also contacted two health and social care professionals after the inspection. We looked at records in relation to 20 people’s care. We also looked at records relating to the management of the service, recruitment, training, and systems for monitoring the quality of the service.

Updated 4 October 2016

Hales Group Limited - Lowestoft, is a domiciliary care service providing personal care to people in their own homes. When we inspected on 18 July 2016 there were 258 people using the service. Most of these people were older adults with needs associated with physical disability, dementia or long term conditions. This was an announced inspection. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to know that someone would be available on our arrival.

There was a registered manager in post. 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.

Staffing arrangements did not always ensure care workers were available to consistently respond to people's assessed needs, and some people experienced late or missed visits. This was in the process of being addressed by the registered manager, and we have made a recommendation.

People were not consistently provided with rotas which gave them details of who would be visiting them for their care visit, and at what time of the day. This left some people feeling anxious and unclear about arrangements. We have made a recommendation about this.

Systems and processes designed to improve the provision of care were not yet fully embedded, which impacted on people receiving care which was responsive to their assessed needs. Staff told us they felt time constraints impacted on their ability to arrive at the next visit on time. We have made a recommendation about this.

A complaints procedure was in place. People’s concerns and complaints were listened to and addressed in a timely manner, however, we found one example where concerns had not been addressed, and feedback received in relation to missed and late visits suggests that this continues to be an area for on-going improvement.

Care workers were knowledgeable of the safeguarding reporting procedures and knew how to respond to any abuse. Staff recruitment systems were robust which ensured that new staff were suitable for their role.

Risk assessments were in place which identified specific risks to people and hazards in their home environment. These were regularly updated.

Care workers understood the principles of the Mental Capacity Act (MCA), and gained people's consent before they provided care. People told us they were encouraged to make choices about their daily lives.

People received the support they required to take their medicines. People were supported to maintain good health and have access to relevant healthcare services.

People told us that care workers were kind and compassionate to them. Care workers were knowledgeable about the needs of the people they supported and helped them to be as independent as possible. They also treated people with dignity and respect.

Care workers were trained in subjects relevant to the people they were caring for, and there was an induction plan for new care workers which ensured they were confident to perform their role.

There were quality assurance systems in place which included feedback from people using the service to help the service know where improvement was required.