All inspections: Hales Group Limited - Huntingdon

Hales Group Limited - Huntingdon is registered to provide a personal care service for people living in their own homes. At the time of our inspection 45 people were using the service.

This inspection was undertaken by one inspector. At the last inspection on 29 December 2015 we found the provider required was in breach of one regulation that we assessed. This was in relation to the management failing to notify us of important events. We received an action plan from the provider which detailed the actions that that they were taking to improve the service. During the inspection we found that the required improvements had been made.

At this inspection we found the service remained ‘Good’.

A registered manager was not in post at the time of this inspection. The branch manager was however in the process of actively applying to become a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Various processes and systems were in place to help keep people safe. These processes included staff's knowledge about managing risks to people and safeguarding them as well as administering medicines as prescribed.

People's assessed care needs were met by a sufficient number of suitably qualified staff. A robust and thorough recruitment process was in place and this helped ensure that staff recruited were suitable to work with people who used the service.

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

People’s needs were assessed by skilled staff who then implemented people's care and support based upon people's preferences. People and their relatives were given information about their care in a format that people could benefit from.

People's health and nutritional needs were met by staff who had been trained on subjects appropriate to people's care needs. Staff respected people's choices of food and drinks. People had access to health care professionals, when they needed them.

Staff were aware of what was expected of them and implemented the values of the provider in providing dignified and individualised care.

A range of effective audits and quality assurance systems were in place to assess, monitor and improve the service. Improvements in the way the service was managed had been made including notifying the CQC about important events.

People's, staff's and relatives views about the quality of the service were sought through face to face meetings, surveys and telephone calls. Feedback was used to recognise good practice and to drive improvements where shortfalls were identified.

Further information is in the detailed findings below.

Hales Group Limited – Huntingdon is registered to provide personal care to people who live in their own homes. The service's registered office is located in the town of Huntingdon. At the time of our inspection there were 50 people using the service.

This unannounced inspection took place on 29 December 2015.

The service did not have 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.

Staff were recruited through a robust recruitment and induction process. This helped ensure that the quality and suitability of staff met legal requirements. People were supported with their needs and preferences by trained and experienced members of staff.

Staff were trained and had their competence to safely administer medicines safely regularly assessed. Safe medicines administration practices were adhered to. Staff had acquired the skills to be confident in identifying and reporting any harm should this ever occur.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The regional manager and staff were knowledgeable about the situations where an assessment of people’s mental capacity could be required. No person using the service lacked the capacity to make informed decisions. The regional manager and staff were aware of the procedures to follow should a person need to be lawfully deprived of their liberty. Staff had an embedded understanding of the MCA.

Staff knew the people they cared for well, what their care needs were and how to respect their preferences. People’s care was provided with dignity and compassion by staff who adhered to good standards of care. People were given the time they needed to make decisions about the aspects of their lives that were important to them.

People, their relatives and staff were involved in planning the provision of people’s care. Advocacy arrangements were in place to support those people who required someone to speak up on their behalf. Regular reviews of people’s care were completed to help ensure that people were provided with care and support based upon their latest information.

People were supported to access a range of health care professionals including community nurses and a GP. Staff responded promptly and action was taken for any identified change in people’s health care needs.

People were supported to ensure they ate and drank sufficient quantities. People had the choice to eat their preferred choice of food and drink where they wanted to. Diets according to people’s health needs were provided.

People were supported to raise concerns or suggestions in a way which respected their rights. Staff responded quickly to any changes to people’s individual circumstances if the person was not happy. Information and guidance about how to raise compliments or concerns was made available to people and their relatives.

Audits and quality assurance procedures were in place. However, not all audits were effective. The provider had not always notified the CQC of events that they are required, by law, to do so.

Information from managers’ forums was used to help ensure good practice was identified and shared with staff at the service. Support was provided to develop staff’s skills and obtain additional care related qualifications.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

During our inspection on 18 April 2012 we found that the provider was not compliant with the regulation relating to staffing. They had not ensured there were sufficient numbers of staff employed for the purposes of caring for people. The provider also required care staff to work excessive hours and very long shifts which put staff and people using the service at risk. We also found that the provider was not compliant with the regulations relating to records and were not updating paperwork to reflect changes needed to ensure the care and treatment of people who used the service was accurate.

During our inspection on 22 April 2013 we found that improvements had been made. Staffing levels had been reviewed and recruitment had taken place. Working arrangements for staff had been reviewed to ensure staff were not working excessive hours.

Care plans had been updated and reflected the current care and support needs required by people who used the service.

During our inspection we found that people and their relatives were involved in decisions taken about care and support. One person told us, " I feel safe with the people who come in and care for me. They are friendly and polite, lovely staff. They sit down and chat with me and talk about how things are going'.

A safeguarding policy for vulnerable adults was in place and staff had undertaken training. Information was available in the homes of people using the service informing them of how to raise a concern.

We visited two people using the service in their homes and spoke with ten people by telephone. We also spoke with two relatives by telephone. People told us that the agency's carers were sometimes late and, occasionally, very late. On rare occasions, people's care calls had been missed altogether. People using the service told us that they were not always informed when their carer was going to arrive later than scheduled and that this sometimes caused them discomfort and anxiety.

Three people told us they had received care calls at an unreasonably early time and another said that their bedtime call was at 6p.m. which was too early for them. Most people told us that they usually saw regular carers, but two people said that they were quite often visited by care staff they do not know. We noted that one person's medication charts had been signed by twenty different staff members during the first three weeks of April 2012.

Most people we spoke with were happy with the care they received. One person told us, 'I like the carers who come to see me. I trust them to do my shopping and to help me with my medication. I did once contact the out of hours service and the response I got was a bit delayed.' One relative told us that their family member, 'Really enjoys seeing the carers and they are very good with them. They give them peace of mind at night by closing curtains and ensuring that doors are locked. Where we have had issues, we have raised these with the manager and they have been dealt with to our satisfaction.' Three people using the service said that they would like to have meals with more fresh ingredients, rather than microwave lunches. One person told us that staff did not always have the skills to provide this.

Most of the people that we spoke with were happy with their visits from the care staff. One person said "Nobody makes me feel hurried. They always make sure I am comfortable." However, some people said that some care staff seemed to be less knowledgeable about their needs and how to care for them.

Some people told us they do not always receive calls at the expected times. Some people do not always receive a weekly schedule so that they know who to expect and what time they will call.

People knew how to make a complaint but some did not feel they had the opportunity to give feedback about the service.

Archived: Hales Group Limited - Huntingdon

All Inspections

1 March 2017

During a routine inspection

29 December 2015

During a routine inspection

22 April 2013

During a routine inspection

18 April 2012

During an inspection looking at part of the service

5 October 2011

During an inspection in response to concerns