Archived: Home First

Updated 10 April 2019

The 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:

One adult social care inspector carried out this inspection.

Service and service type:

Home First is a reablement domiciliary care agency. It provides personal care to adults living in their own houses and flats in the community.

The service did not have a manager registered with the Care Quality Commission; the deputy manager had submitted all relevant paperwork and was awaiting an interview to become the registered manager. Registered managers along with the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We gave the service five days’ notice of the inspection site visit because we needed to be sure they would be in. Inspection site visit activity started on 05 March 2019 we visited the office location on the same day to see the operational service manager, deputy manager and office staff; and to review care records and policies and procedures. We telephoned people and relatives on 05 and 06 March and contacted staff on 07 March 2019.

What we did:

Before our inspection, we checked the information we held about Home First. This included notifications the service sent us about incidents that affect the health, safety and welfare of people who received support.

We also contacted the commissioning, safeguarding and contracts departments at Herefordshire County Council. This helped us to gain a balanced overview of what people experienced when they received support from Home First. We also contacted Healthwatch. Healthwatch is the local consumer champion for health and social care services. They give consumers a voice by collecting their views, concerns and compliments through their engagement work. All the information gathered before our inspection went into completing a planning document that guides the inspection. The planning document allows key lines of enquiry to be investigated focusing on any current concerns, areas of risk and good or outstanding practice.

During the inspection, we spoke with four people who received support, six relatives, the operational service manager, deputy manager and senior therapist. We also spoke with one member of the office staff and five care staff. We looked at the care records of six people, recruitment and training records of two staff members, records related to the administration of medicines and the management of the service.

We looked at what quality audit tools and data management systems the service had. We reviewed how many visits a staff member had completed per day and if the management team ensured staff had enough time to travel between visits. We looked at the continuity of support people received and discussed how the management team monitored how long staff stayed on each visit.

We used all the information gathered to inform our judgements about the fundamental standards of quality and safety of the service delivered by Home First.

Updated 10 April 2019

About the service: Home First is a reablement service that provides short term domiciliary care. It provides personal care to adults living in their own houses and flats. At the time of the inspection 48 people received personal care support from the service.

People’s experience of using this service:

Relatives told us family members were made safe by the care they received. Staff told us they had appropriate training, knowledge and support to keep people safe. Staff could tell us how they managed risk and behaviours that challenge while respecting the person and supporting their dignity.

People and relatives felt confident in staff, they told us there was a caring culture within the service and staffing levels were appropriate.

We looked at how the management team planned their rotas. Staff were given travelling time between visits to ensure people received their allocated and appropriate support.

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.

Care plans had been developed with people and their relatives being involved throughout the process. These were reviewed to reflect people’s current needs. The guidelines were under review to ensure outcomes were clear and measurable and promoted the person’s reablement. The management of risk was included within the care plan to minimise the likelihood of preventable harm occurring.

We saw staff files showed the registered manager used the same safe recruitment procedures we found at our last inspection. Staff told us training was ongoing and they received refresher training to update their knowledge.

There was a complaints procedure which was made available to people and their families. People told us they had not made a formal complaint. The service continued to have good oversight of relevant procedures through monitoring and auditing to ensure people received effective support and the service was well led.

The management team used a variety of methods to assess and monitor the quality of the service. These included questionnaires to seek their views about the service provided.

The service worked in partnership with outside agencies, health and social care professionals to ensure people received timely healthcare support.

Rating at last inspection: Good (Report published 03 May 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any issues or concerns are identified, we may inspect sooner.

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