About the service Harlestone Home Care Ltd is a domiciliary care agency providing personal care and support to 29 people in their own houses and flats.
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
Complaints had not been recorded. One person had made a complaint that had not been recorded and responded to in line with provider’s policy and had resulted in legal action. Another person’s verbal complaint had not been recorded but they told us they had received a verbal response. Following the inspection, the registered manager implemented a system for recording monitoring and responding to complaints.
People and staff told us that the service was currently short staffed. This had not impacted on the safety of people or staff, but people told us they were not always getting their calls at their preferred times and they weren’t always told by the office team which staff members would be visiting them. The registered manager had a contingency plan which deployed trained office staff to cover care staff shortages.
The registered manager had not consistently maintained oversight of training with some training refreshers now overdue. Staff supervisions had not been completed as per the providers policy. However, these issues had been identified prior to our inspection and systems had been implemented to improve oversight, this would now need to be continued and embedded in practice. Staff received an induction and thorough training prior to working with people.
People were assessed prior to starting with the service. Their religion, culture, likes dislikes and choices were all considered and planned into care. People had personalised risk assessments in place and told us that staff listened to their choices and preferences. Some people could not recall having a review of their care, records showed regular updates were in place. The registered manager felt that this was because reviews are kept friendly and informal to put people at ease. We have made a recommendation around ensuring people are aware when reviews and updates are taking place.
Systems and processes protected people from the risk of abuse. Staff had a good understanding of the whistleblowing procedure and how to keep people safe. Incidents and accidents were recorded, monitored and actioned appropriately.
Medicines were managed safely with regular audits taking place. People told us they got their medicines when they needed them. People were protected from the spread of infection. Risks to people were assessed and planned into care delivery.
Staff had developed good relationships with people and people found them to be kind, caring and respectful. People were well supported with eating and drinking where needed. The staff and management team worked in partnership with other professionals to ensure people were supported with their health and social care needs in a timely manner.
People’s communication needs were considered, and information could be made available for people in easy read pictorial and other languages when required.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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 25 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified a breach of regulation in relation to receiving, recording and acting on complaints.
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 for the provider to understand what they will do to improve. 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.