Hales Group Limited - Ipswich

Updated 24 January 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was undertaken by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in [their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. The previous registered manager deregistered on 5 December 2022. There was a new manager in post who told us they were in the process of submitting their application to become registered manager.

Notice of inspection

We gave a short period notice of the inspection 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 7 December 2022 and ended on 21 December 2022. We visited the location’s office/service on 9 December 2022.

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 (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with six people who used the service and nine relatives of people who used the service. We spoke with the manager, the director of East and South Region and four care workers, we also received electronic feedback from one care worker.

We reviewed eight people’s care records, three staff recruitment files and a range of records relating to governance, including staff training, audits, policies and procedures, and lessons learned documents.

We fed back our findings of the inspection to the manager and director of East and South region on 21 December 2022.

Updated 24 January 2023

About the service

Hales Group Limited – Ipswich is a domiciliary care service providing personal care to people living in their own homes. 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. At the time of our inspection there were 45 people using the personal care service.

People’s experience of using this service and what we found

At the time of the inspection, the location did not provide personal care for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support:

Not all of the people we received feedback from felt listened to by their care workers. The manager had plans to speak with all people about their experiences and recent satisfaction surveys had been sent out. They assured us actions would be taken as a result of feedback received.

Right Care

People’s care plans were not always kept up to date to guide care workers in the care required. The management team had started to improve in this area, but this was not yet fully implemented.

Right Culture

There had recently been a change of management in the service. The management team knew where they needed to make improvements, had an action plan in place, which they were working on. All improvements had not yet been fully implemented and embedded in practice.

Improvements were needed in how risks were assessed and mitigated; this includes ensuring all risk assessments were being kept up to date. There were shortages of staff, which the service was taking action to address and limit the impact on the safety of people.

We found that care plans, risk assessment and monitoring of staff had not been kept up to date. This had been identified by the service and improvements were in the process of being implemented.

There were visits which were not being undertaken for the planned time, travel time between visits was not always provided and care workers were found to be logged in to visits to multiple people at the same time. We were assured this would be addressed to limit the risks of people not receiving the care they required.

The service had systems to monitor that people received their medicines, where required. Where shortfalls were identified actions were being taken to address them. Care workers were guided in infection control and the use of personal protective equipment (PPE). However, we received feedback that not all care workers were wearing all the PPE.

Care workers were recruited safely. There were systems in place to learn lessons when things went wrong and use them to drive improvement.

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 good (published 3 October 2018).

Why we inspected

The inspection was prompted in part due to concerns received about lack of staff, late and short visits, the lack of travel time provided between visits, safe care, governance, systems to monitor staff not being kept up to date and care plans not being reviewed to ensure they were kept up to date. In addition, there was a recent change of management in the service. Following concerns received, we had undertaken a range of actions, including contacting the service for assurances, informed the local authority commissioners and/or raised a safeguarding referral with the local authority. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe 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 full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hales Group Limited - Ipswich on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.