We carried out a review of the data available to us about HQ Priory Care Services on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about HQ Priory Care Services, you can give feedback on this service.
People’s experience of using this service and what we found
New processes were in place to identify and manage risks to people’s safety. This included liaising with health and social care professionals if staff identified changes in people’s health or risk behaviour. New medicines management processes had been implemented to ensure people received their medicines as prescribed. Safe recruitment practices were now in place and there were sufficient staff to meet people’s needs. Staff followed safeguarding adults’ procedures and adhered to incident reporting processes. Staff adhered to infection prevention and control procedures.
Staff were now in adherence with the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff had attended refresher training and were supported to attend training courses and develop their knowledge and skills. Staff assessed people’s needs in line with best practice guidance. Where people required, staff supported people with their nutritional needs and supported them to access health services.
People were complimentary about their care workers and the relationships they had formed. Staff took account of people’s individual differences when allocating care workers. People were involved in decisions about their care and how they were supported. Staff respected people’s privacy and dignity, and enabled them to be as independent as possible.
Care records had been reviewed and improved. Staff worked with people and their relatives to identify their care needs and how they wished to be supported. There were regular care reviews to ensure people’s records reflected their current needs. Staff adhered to the accessible information standard. There were processes in place to manage and learn from complaints.
A new registered manager and field care supervisor were in post which provided a new approach to management and oversight of the service. New robust systems had been introduced to review the quality of care delivery and ensure continuous improvement. An open and honest culture had been developed which encouraged staff, people and their relatives to provide feedback about the service. The registered manager was aware of their CQC registration requirements and their responsibilities under the duty of candour.
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 28 February 2019).
The provider completed an action plan after our inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating and to follow up on action we told the provider to take at the last inspection.
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.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. The agency provides a service to adults with physical disabilities and older people, including people living with dementia. Not everyone using HQ Priory Care Services 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 61 people were provided with personal care by the agency. The service had a contract with the local authority to provide people with domiciliary services.
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.
People felt safe with the care provided and with the staff who supported them. However, the provider’s risk assessments and risk management plans did not have adequate guidance for staff to follow to minimise possible risks to people.
Care plans did not include all the information staff needed to care and support people in line with their needs and preferences. This was despite the service being provided with relevant assessment information from the local authority.
Medicines were not managed in line with current guidance. Incomplete information and lack of instructions on how medicines should be administered meant that people may not always receive their medicines safely and as prescribed.
The principles of the Mental Capacity Act (2005) were not always followed to make sure people's rights were protected.
The provider had some systems in place to monitor and improve service delivery. This included a complaints system, telephone feedback and observations of staff practice. Other quality assurance systems needed development to ensure that all aspects of the service were effective and meeting people’s needs.
Despite the above shortfalls, people and relatives were happy with the care provided and told us they experienced a flexible service. People were treated with kindness and respect and supported by the same staff which provided consistency of care.
People felt that staff respected their privacy and dignity and helped them to remain as independent as they could.
People had information on how to make a complaint and knew how to do so.The provider responded appropriately to any complaints they received.
We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to managing risk for people using the service, care planning, consent, staff recruitment and governance. We have also made a recommendation about staff training on the management of medicines. You can see what action we told the provider to take at the back of the full version of this report.