Archived: Hands on Care (Wombourne) Limited

The provider is registered with us to provide personal care and support for people who live in their own homes. At the time of our inspection visit, they were supporting 19 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People continued to receive calls that were not always of the correct duration and people did not always know which staff would be attending their calls. The systems the provider had in place did not always identify these concerns and when they did, action was not always taken to make improvements.

There were several gaps on medicine administration records and the systems in place had not identified these. Action was not always taken to see if people had received these medicines or not.

The systems the provider had introduced since our last inspection were not always effective in identifying areas of improvement or making changes to the service. Not all incidents had been fully investigated or reported by the registered manager. People were asked to give feedback on the service however this was not always considered, and changes made.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

People were happy with their care and the support they received. Staff knew people well and had adequate training to support them. People were protected from potential harm and individual risks to people were considered and reviewed. Infection control procedures were considered and followed. Some lessons were learnt when things went wrong.

People were encouraged to make choices, remain independent and their privacy and dignity was maintained. People were offered assistance with meals and received support from health professionals when needed. There was a complaint procedure in place and people felt ale to complain. Staff felt supported and listened to.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Requires Improvement. (Published 21 February 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough, improvement had not been made and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the governance systems at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Not everyone using Hands on Care (Wombourne) Limited receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At our last inspection in February 2018 we identified improvements were needed under the key questions of is the service safe, effective, caring, responsive and well-led. We identified four breaches of the Health and Social Care Act 2008. Following our inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question(s) is the service safe, effective, caring, responsive and well-led to at least good. We issued a Notice of Decision in relation to Good Governance. A Notice of Decision is one of our enforcement powers.

This inspection took place on 22 November 2018 to follow up on our previous findings. We returned to check the necessary action had been taken to improve the quality of care and reduce any risks to people. During this inspection the service demonstrated that some improvements had been made, however, further improvements continued to be required in relation to Good Governance.

There were two registered managers in post at the time of the inspection. 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.

Although people were supported by enough safely recruited staff they did not always receive their calls at their allocated time. People were protected from the risk of abuse. Risks to people had been assessed and were managed appropriately. People told us they received their medicines as prescribed. Staff had access to personal protective equipment (PPE) to help prevent the spread of infection.

People’s needs were assessed and care records were in place for staff to follow. Staff had access to training and had their competencies checked to ensure they continued to provide safe care. People were supported with their dietary needs and accessing healthcare professionals when required. People consent was sought before staff provided care and staff understood the principles of the Mental Capacity Act.

Although people told us staff were kind they sometimes experienced rushed, late and short calls. People said their dignity and privacy was respected. People were encouraged to remain as independent as possible and were involved in their care planning.

Care records contained information about people’s needs and what was important to people. People knew how to complain however were not always confident their concerns would be acted upon.

Some improvements were found in the governance systems however, we identified further improvements were required in relation to identifying themes and patterns. Quality assurance systems were not fully effective in improving the quality of service provided to people. This is the fourth consecutive inspection whereby the provider had failed to achieve a ‘Good’ rating in the well-led question.

Hands on Care is a domiciliary care agency. It provides personal care to people living in their own houses in the community. It provides a service to older adults. Not everyone using Hands on Care receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of our inspection, 21 people were supported with their personal care needs by the service. 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.

Although people felt safe with the care they received in their homes; an adequate system had not been established to investigate allegations or evidence of abuse. Risk assessments and guidance was not always in place to ensure specific issues were identified and managed safely.

People regularly experienced late and shortened calls. The provider had a recruitment system in place but this was not followed and appropriate pre-employment checks had not been completed.

People received their medicines as prescribed and staff had the skills to meet their needs. People told us staff were kind and caring and sought their consent before providing care. People told us they were treated with dignity and respect and were involved in how their care was planned. Staff promoted people’s independence. Staff supported people to meet their nutritional needs.

Although people knew how to raise concerns an effective complaints system was not in place. The quality assurance system was not effective at identifying concerns or driving improvement.

During this inspection we found breaches in 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 this report.

Hands on Care (Wombourne) Ltd provides personal care to people with a range of needs in their own home. At the time of the inspection they were providing a personal care service to 22 people.

There was a registered manager in post at the time of our inspection, who was also a company director for Hands on Care. 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.

People felt safe with the staff, and were confident the care they received was provided in a way that ensured they were safe. People felt staff were managed in a way that ensured they came when needed, and had time to provide the care and support people wanted. Risks to the health, safety or wellbeing of people were identified and staff understood these. The service had improved how they recruited new staff so that they were of a suitable character to support people. People felt their medicines, when administered by staff, were managed safely.

People felt staff were well trained and had the knowledge and skill to meet their individual needs. People’s rights were promoted and people said their consent was always sought. People felt they were well supported with their food and drink, when they received this support. People were helped to access healthcare professionals by staff when required.

People felt staff were kind, caring and respectful. People’s dignity and privacy was respected and they felt involved in making decisions and choices about how their care was delivered and planned. People’s independence was promoted by staff.

People’s needs were assessed and any changes needed to their care in response to their health or circumstances were met by the service. Staff were aware of people’s needs and preferences. People knew how to complain and were confident any complaints would be addressed appropriately.

The provider was developing their systems to monitor the safety, and quality of care people received although these needed to be fully embedded so that improvements made were maintained. People were able to share their views with the service and were confident changes would be actioned if needed. Staff felt well supported by the registered manager.