Background to this inspection
Updated
23 October 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by an inspector and an Expert-by Experience who carried out telephone interviews. An Expert-by-Experience is a person who has personal experience of using or caring for someone who uses this type of care service for older people.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and 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 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 16 August and ended on 24 September. We visited the office location on 16 August 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with the provider, a director, registered manager, senior care co-ordinator and a co-ordinator. We reviewed a range of records. This included six people’s care records and five medicines records. We looked at three staff files in relation to recruitment and staff training. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
After the site visit we tried to contact 69 people who used the service. We spoke with eight people and 12 relatives of people who used the service. We spoke with one care co-ordinator and 11 support workers. We looked at training data and quality assurance records.
Updated
23 October 2019
About the service
Heritage Healthcare is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to younger and older adults. At the time of inspection 120 people were using the service.
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 told us they felt safe and were well-supported. There were sufficient staff hours available to meet people's needs in a safe and consistent way, and staff roles were flexible to allow this. Staff had received training about safeguarding and knew how to respond to any allegation of abuse.
Systems were in place for people to receive their medicines in a safe way. Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks.
Staff had a good understanding and knowledge of people’s care and support needs. They received the training they needed and were well-supported. The service assisted people, where required, in meeting their health care and nutritional needs.
People were positive about the care and support they received from care workers. Staff had developed good relationships with people, were caring in their approach and treated people with respect.
Improvements were required to some systems to ensure that care was person-centred and that people were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
There were some opportunities for people, relatives and staff to give their views about the service. The provider undertook a range of audits to check on the quality of care provided. We advised that more regular consultation with people would give them the opportunity to feedback to ensure person-centred care was being provided.
People and staff said improvements were required to communication. Processes were in place to manage and respond to complaints and concerns.
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 18 August 2018).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.