Care Hearted West Midlands

Updated 24 November 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 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 Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors and an assistant inspector.

Service and service type

Care Hearted West Midlands is a domiciliary care agency. It provides personal care to people living in their own homes.

The service did not have a manager registered with the Care Quality Commission in line with the requirements of the provider's registration. When registered, this means they are legally responsible for how the service is run and for the quality and safety of the care provided with the Care Quality Commission.

Notice of inspection

This inspection was announced. We gave the nominated individual short notice of the inspection. This was because we needed to be sure that they would be available to support the inspection. Inspection activity started on 07 October 2021 and ended on 25 October 2021. Two inspectors visited the office location on 07 October 2021.

What we did before the inspection

We reviewed the information we had received about the service since registration. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We also gathered feedback from the local authority who fund the care provided. We used all of this information to plan our inspection.

During the inspection

During our visit we spoke with the human resources director, the quality assurance manager, the administrator and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included five people's care records, three staff recruitment records, and records of the checks the managers completed to assure themselves people received a safe and good quality service.

After the inspection

We spoke with the nominated individual and received information from them to validate the evidence we found. An assistant inspector spoke with two people and three people's relatives on the telephone about their experience of the care provided. An inspector gathered telephone feedback from two staff members to find out what it was like to work at the service.

Updated 24 November 2021

About the service

Care Hearted West Midlands is a domiciliary care service providing personal care to people in their own homes. At the time of the inspection 35 people received personal care.

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

The providers systems to monitor the quality and safety of the service required improvement. Whilst we acknowledged some improvements had been made since July 2021 issues that we found during this inspection had not been identified and addressed. That demonstrated effective governance systems were not in place. The management team welcomed the inspection and were open and honest about the challenges they had faced.

Whilst people told us they received their medicines when they needed them the provider was unable to demonstrate the management of medicines was consistently safe. Action was being taken to address this. Staff had completed training in safe medicines management and their competency to administer medicines safely had been assessed by their managers.

People's needs were assessed before they started using the service. However, assessments needed to be further developed to ensure protected characteristics under the Equality Act 2010 were fully considered.

Information contained within people’s care records varied and the providers approach to care planning and involving people in their care was inconsistent. The nominated individual acknowledged these areas needed development. Action was being taken to make improvements.

People felt safe with their care workers and safeguarding procedures protected people from harm. Managers and staff understood their responsibilities to keep people safe. Staff knew how to manage risks associated with people’s care, but risk management plans did not always contain the information staff needed to help them provide safe care.

Staff were recruited safely. The provider was actively trying to recruit new staff including a manager. Enough staff were available to provide the care and support people needed and people told us the times staff arrived to provide their care had recently improved. People’s confidence in the leadership of the service had increased but it was not evident how feedback gathered from people had been used to drive forward improvement. People knew how to complain but more needed to be done to demonstrate lessons had been learnt to improve quality when complaints had been received.

Risks associated with COVID-19 had not always been assessed in line with the providers policy and national guidance. People told us staff followed safe infection and prevention and control practice in their homes. Staff had completed training in this area to protect people from the risks of infection.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People received their care from a small number of consistent staff who they knew and trusted. People and relatives had confidence in the ability of the staff to provide effective care. Staff had completed an induction when they had started work at the service. Staff training records were updated after our visit to accurately reflect the training staff had completed.

Whilst staff knew what people liked to eat and people spoke positively about the way staff prepared their meals more information needed to be added to care records to ensure meals were prepared in line with peoples wishes. The service worked with other professionals to improve outcomes for people.

People and their relatives told us staff were kind and caring and staff knew the people they cared for well. People were respected, and staff explained how they maintained people’s privacy and dignity. Staff felt supported, enjoyed their jobs and understood what the management team expected of them.

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

Rating at last inspection

This service was registered with us on 06 November 2020 and this is the first inspection.

Why we inspected

This was a planned inspection of this newly registered service. The inspection was prompted in part due to the information we had gathered during our monitoring of the service in July 2021.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service/We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified one breach of the regulations in relation to good governance and have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.