Archived: Hayes Staff Recruitment Limited (Hayes Branch)

At our last inspection in January 2017, we rated the service Requires Improvement overall and in the key questions of ‘Is the service safe?’ and ‘Is the service well-led? We also found a breach of Regulation 18 of the Registration Regulations in that the registered manager had not notified the commission in a timely manner of any injury and/or allegation of abuse in relation to a person using the service as required by law. During this inspection, we found that the registered manager was meeting this regulation and we found the service to be Good overall.

This service is a domiciliary care agency and provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, younger adults, and children with learning disabilities.

At the time of our visit, the provider offered a service to 73 people. However not everyone using Hayes Staff Recruitment (Hayes Branch) received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’ and 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 visit, 27 people received the regulated activity.

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.

Relatives described care staff as good and caring. Staff demonstrated they knew how to build a positive relationship with the people they supported.

Staff followed health care professionals’ guidance and people were supported to access appropriate health care. Care staff recorded what people ate and drank to monitor their nutrition and hydration. Care staff reported any concerns about people’s health to the registered manager or office staff so they could take appropriate action.

The registered manager ensured there was ongoing recruitment to meet the staffing requirements within the service. The provider had robust recruitment procedures to ensure care staff employed, were safe to work with people. Staff were offered training and support to develop their skills.

The management team had undertaken risk assessments to identify and mitigate the risks associated with the delivery of care in a person’s home and when out in the local area.

Care staff had received training to administer medicines safely. They were provided with clear guidance about the type of support people needed with their medicines. Staff understood safeguarding procedures and knew to report any concerns.

The management team understood their responsibility under the Mental Capacity Act 2005 and ensured people’s rights were being upheld. Staff demonstrated they asked people’s consent before proving care and support.

The registered manager met with people and their family and undertook an initial assessment before providing care and support.

People had person centred plans that gave guidance to staff about how they wanted their care delivered. Care plans were reviewed on a regular basis to capture people’s changing circumstances. The registered manager worked with people’s families, other agencies, health and social care professionals including schools and colleges to ensure care plan information was up to date and accurate.

People and relatives said they knew how to complain and the registered manager addressed complaints in a timely manner.

The registered manager had a good oversight of the way the service was provided because they had quality assurance systems including audits and checks to ensure the quality of the care provided.

The provider had joined a national organisation and the registered manager had accessed training to ensure they kept abreast of good practice.

The last inspection took place on 2 February 2016. At this inspection, we found the agency was not meeting all the required Regulations. In particular, we observed that people were not always safe as the agency did not ensure safe management of medicines, people had not consented to their care and treatment, and there were no effective systems in place to assess, monitor and improve the quality of the service. The agency had supplied us with an action plan telling us they would make the necessary improvements. At the inspection of 11 and 12 January 2017, we found improvements had been made and further improvements were needed in some areas.

Hayes Staff Recruitment Limited is a home care agency which provides personal care and support to children and adults with learning disabilities, physical disabilities and mental health needs. The majority of people have their care funded by the London Boroughs of Ealing and Hillingdon.

At the time of our inspection, the agency provided approximately 722 hours of support on a weekly basis to 85 people out of which 29 received personal care.

There was a registered manager in post. The previous registered manager left the agency in September 2016, a new manager took over in October 2016. 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 and associated Regulations about how the service is run.

The agency carried out investigations into all accidents, incidents and complaints raised by the people using the service and their relatives but had not notified CQC of these as potential safeguarding alerts.

People and their relatives told us they felt safe when receiving support from the agency.

Staff received safeguarding training. They were able to describe potential signs of abuse and were aware of the agency’s safeguarding policies and procedures.

The agency had systems in place to ensure staff administered medicines in a safe way and as prescribed.

Staff received medicines training and a medicines policy was available to staff for guidance.

Risks to people’s health, safety and welfare had been assessed, management plans were in place and the agency had taken action to minimise the risks of harm.

The agency had robust recruitment procedures in place to ensure only suitable staff were appointed to work with people who used the service.

The agency had a booking and rota system in place to ensure that all calls were covered. The agency was working on implementing a staff allocation system to ensure continuation of care in case of a sudden staff absence.

CQC is required by law to monitor the implementation of the Mental Capacity Act (MCA) 2005. The agency met the requirements of the Mental Capacity Act 2005. Where people did not have the capacity to consent to specific decisions the staff involved relatives and other professionals to ensure that decisions were made in the best interests of the person and their rights were respected.

Relatives told us they were happy with the care received from the agency and that staff had sufficient skills and knowledge to ensure the best support for people they cared for.

Staff received a detailed induction prior to starting their role as a support worker.

Staff members completed a range of training and there were systems in place to ensure all staff training was up to date.

Staff received effective support in the form of regular one to one supervision, practice observation and yearly appraisals of their practice.

People's health and wellbeing was monitored on a daily basis and staff alerted the agency and other professionals if someone's health needs changed.

People had their dietary needs monitored and staff had guidance to ensure they supported people with food intake in a safe way.

People told us they were treated with dignity and respect by the staff who supported them.

People and their relatives said they were involved in making decisions about their care and that it was reviewed on a regular basis.

The agency had a complaints procedure in place, all complaints were dealt with in a timely manner and the majority of people and their relatives said they were satisfied with the outcomes.

The agency completed monthly audits and the outcomes were used to improve the service quality.

The agency had their own quality assurance survey that was completed by the people who used the service and their relatives on a yearly basis.

Staff members told us the agency was well led, there was a culture of open communication and they could ask the management team for support if needed.

The agency worked in close partnership with the local authority and external health professionals. There was evidence of on-going communication between both parties.

There were up to date policies and procedures available for staff guidance.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At the last inspection on 12 November 2013 we found the service was meeting the regulations we looked at.

Hayes Staff Recruitment Limited is a home care agency that provides personal care and support to children and adults with learning disabilities, physical disabilities and mental health needs. The majority of people have their care funded by the London Boroughs of Ealing and Hillingdon.

At the time of our inspection the agency provided approximately 1150 hours of support on a weekly basis to 108 people out of which 36 were receiving personal care.

There was not a registered manager in post and the previous registered manager left the service in October 2015. 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 and associated Regulations about how the service is run. A manager had been appointed since December 2015 and they told us they were in the process of applying to be registered.

People’s medicines were not always managed safely because the administration was not always recorded correctly.

People’s mental capacity and ability to make decisions was not recorded in their care plans and there were no records showing that people consented to their treatment or that care decisions had been made in their best interest.

The service’s quality assurance systems were not always effective and consequently the service delivered was affected.

People had risks to their health and wellbeing assessed and managed.

Staff received medicines training and a medicine policy was available to staff for guidance.

All of the people using the service had an environmental risk assessment completed that consisted of general information on risks to people’s health and wellbeing.

The service had a rota system in place to ensure that all staff members knew who they were assigned to visit and that all staff planned absences were covered.

People were protected from harm and abuse. Staff received safeguarding training and they were aware of safeguarding policies and procedures.

The management team carried out prompt and detailed investigations into all safeguarding concerns, accidents, incidents and complaints raised by the people using the service, their relatives, staff and external professionals.

The service had robust recruitment procedures in place to ensure only suitable staff were appointed to work with people who used the service.

Relatives told us they were happy with the care received from the service and that staff had sufficient skills and knowledge to ensure the best support for people they cared for.

Staff received a detailed induction prior to starting their role as a care worker.

Staff members completed a range of training and there were systems in place to ensure all staff training was up to date.

People’s health and wellbeing was monitored on a daily basis and staff alerted the agency and other professionals if someone's health needs changed.

People had their dietary needs monitored and staff had guidance to ensure they supported people with food intake in a safe way.

People told us they were treated with dignity and respect by the staff who supported them.

People and their relatives said they felt involved in making decisions about their care and that it was reviewed on a regular basis.

The service had a complaints procedure in place and all complaints were dealt with in a timely manner.

The service had their own satisfaction survey that was completed by the people who used the service and their relatives on a yearly basis.

Staff members told us the service was well led, there was a culture of open communication and they could ask the management team for support if needed.

The service worked in close partnership with local authority and external health professionals and there was evidence of ongoing communication between both parties.

There were up to date policies and procedures available for staff guidance.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People told us the agency had involved them in decisions relating to their care and always looked after their interests. Most of the people we spoke with told us they were happy with the support provided. People said that care workers were punctual, caring and treated them in a respectful way. People said their care workers were adequately trained to meet their needs.

People were protected from abuse, the provider had safeguarding procedures in place and they were being followed by staff. Staff had received training in safeguarding adults and children and the training had been regularly updated.

There were arrangements in place to monitor the quality of the service including telephone calls to obtain people's feedback of the service, annual satisfaction surveys, spot checks of care workers and audits of people's care records.

One person said, 'the staff are very good, they are always on time, and I have no complaints at all'. One person told us that they once received care from a staff member who was not willing to help and they were unhappy with the care but once they spoke with the agency this staff member stopped providing their care and they were happy with the replacement staff.

People told us that they received visits from a field officer when their care plans were reviewed with their involvement, and they spoke with the manager frequently to give feedback on all aspects of the care they were receiving.

People told us they were aware of the complaints procedure, but had never needed to complain.

Staff told us that they were not allowed to start work with the agency until all recruitment checks had been carried out and they had completed induction training.

We found that the provider carried out quality assurance checks and the majority of people had expressed that they were happy with the care provided in surveys that had been completed