Background to this inspection
Updated
12 July 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 team consisted of one inspector and an Expert by Experience who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience made phone calls to people to ask about their experience with the service.
Service and service type:
This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing.
The service did not have a manager registered with the Care Quality Commission during the time of our inspection, but as they were looking to move locations the current manager (who was registered for another of the provider’s services) was going to register at the point the new location was registered. An application for this was received by CQC. Registered persons 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:
This inspection was announced. We gave the service 48 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 and we also needed to be sure people consented to us contacting them for their views.
Inspection activity started on 28 May 2019 and ended on 11 June 2019. We visited the office location on 30 May 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 this information to plan our inspection.
During the inspection:
We spoke with seven people and two relatives of people who used the service. We spoke with, two support workers, one senior care coordinator, one field care co-ordinator, the manager, area manager and quality lead. We used this information to form part of our judgment. We looked at three people’s care records to see how their care was planned and delivered, this including their medication records. Other records looked at included recruitment files to check suitable staff members were recruited and received appropriate training. We also looked at records relating to the management of the service along with a selection of the provider’s policies and procedures, to ensure people received a good quality service.
Updated
12 July 2019
About the service:
Harmony Care is a domiciliary care agency that provides personal care within people’s own homes for younger and older adults with a variety of needs, including people living with dementia, learning disabilities or autistic spectrum disorder, mental health conditions or a physical disability. At the time of our inspection the agency was supporting 70 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:
Quality monitoring systems included audits, spot checks on staff practice and regular checks on people’s satisfaction with the service they received, by surveys, phone calls or visits from the service’s management. The provider had recognised the service needed to improve following our previous inspection and people and staff told us there was improvement. These improvements needed to be embedded into usual practice as there were still some areas where people said there could be some improvement, for example for some people felt less staff visiting and consistent provision of rotas (so they knew which staff were coming) was needed.
People and relatives told us they felt safe with care staff and staff were able to demonstrate a good awareness of each person's safety and how to minimise identified risks. People and care staff told us they were able to attend people’s care calls within a timely way and stop for the duration of their planned care call.
People were supported by care staff that were caring. People received care and support based on their individual needs and preferences. Staff were knowledgeable about people, their needs and preferences and used this to develop a good relationship with the people they visited.
People were supported by care staff who had the skills and knowledge to meet their needs. Staff understood, felt confident and well supported in their role. People's health was supported as staff worked with other health care providers when needed to support people’s healthcare needs.
People were supported to have maximum choice and control of their lives and staff understood that they should support them in the least restrictive way possible; the policies and systems in the service supported this practice.
People's care plans reflected people’s needs and preferences and the staff were able to explain recent changes to people’s care. People told us they were involved in assessments of their care needs and reviews were carried out by visiting senior staff.
People knew how to complain and that any concerns would be listened and responded to by the provider. The manager saw complaints as useful feedback from which to develop and improve the service.
People, relatives, staff and professionals gave us an overall positive picture as to the quality of care people received, and said they were able to share their views with staff.
People and relatives told us the manager and staff were approachable, organised, listened and responded to them and acted on feedback when they shared this with them.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update:
The last rating for this service was ‘requires improvement ‘(published 04 December 2018) and there were three breaches of regulation. We had issued the provider with a warning notice in respect of poor governance. The provider completed an action plan after the last inspection to show what they would do and by when they would 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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Harmony Care - Staffordshire (DCA) on our website at www.cqc.org.uk.
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.