This inspection took place on 16, 17, 18, 20, 23 and 24 April 2018 and was announced. This was the first inspection of the service since changing the branding and moving into new premises in Cramlington under a new registration. This service is a domiciliary care agency based in Cramlington, Northumberland. It provides personal care and other additional support to people living in their own homes throughout the east of Northumberland. Services were provided to adults with a wide range of health and social care needs including physical disabilities, sensory impairments, learning disabilities, mental health needs and dementia.
At the time of our inspection there were 597 people receiving a service which was regulated. Not everyone using Helping Hands – East Northumberland received a regulated activity; The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where people receive other support we do take this into account as part of any wider social care provided.
The service had a registered manager in post. The registered manager has been in post since before the service first registered in November 2017 and was well established. A registered manager is a person who has registered with the 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.
Medicine management had improved in some areas with the implementation of new paperwork, but we found further issues that needed to be addressed, including for example, the accurate completion of medicine administration records.
There was no travel time between care calls and missed calls could not always be monitored robustly. We had previously spoken with the provider about this at their other location in the West of Northumberland and they were in the process of purchasing a new upgrade to their IT system which would address these issues.
People told us they felt safe with the care staff who supported them. Staff told us they would report any concerns about the people they cared for and staff had received suitable training. Any safeguarding incidents had been fully recorded and investigated.
There were enough staff employed and the provider had continuous recruitment drives in place to maintain this. People reported that continuity of staff was an issue on occasions, but from the records we checked, scheduling staff had tried their best to main the same care staff. The provider also said the new IT system will further improve this.
Risk assessments and care plans were not always up to date, but the provider was aware of this and were working their way through people’s care records to ensure new paperwork and all relevant documentation was in place. The newer paperwork, however, was much more person centred and enabled staff to have more individual information about each person they cared for.
Accidents and incidents were recorded and monitored for any trends and further discussed at management meetings.
Recruitment of care staff was continuous and the new HR team were working their way through staff records to ensure all relevant paperwork was in place, including three yearly renewed DBS checks. We found some gaps in staff training, supervision and competency checks, however, the provider was aware of these and had employed a new trainer who had already started updating staff training. Key management staff were working their way through the rest of the backlog.
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 told us they were not always asked if they were happy with staff shadowing other staff during visits to their homes. We have made a recommendation about this.
Where food and refreshments were part of a person’s care package, people told us they were happy with the way staff supported them. Where a person needed additional support from outside healthcare professionals, they were supported by staff at the service and we saw evidence of this.
People and their relatives were very complimentary about the care staff who supported them. People were respected and their dignity and independence maintained by staff who cared. We saw examples of the caring relationship which care staff had developed with people and their families and we were given lots of examples of good practice.
People and their families knew how to complain and complaints we reviewed had been dealt with in a timely and proper manner.
The provider had a clear vision for the service and had introduced as part of this; rebranding, including new uniforms, new office environment, new website, new paperwork and a range of new processes. The more complex people who were cared for, were managed by the specialist team. This team now had newly appointed manager's which included the head of the team and a manager for its day to day operation.
Audits were in place but they were behind in their completion for medicines and therefore had not found the issues we had during the inspection.
Policies were in place and some were still under review. We have made two recommendations regarding the accident and incident policy and the receiving of gifts policy and procedures.
The results of a survey had been just recently sent out to people and showed that generally they were satisfied with the service. However, where issues had been raised, the provider gave reassurances that action would be taken.
We found one breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to safe care and treatment
You can see what action we told the provider to take at the back of the full version of the report.