15 April 2021
During a routine inspection
UR Hands Care is a domiciliary care agency providing personal care to people living in their own homes. The domiciliary care agency provides a service to older people, people living with dementia and people with physical disabilities. At the time of inspection there were three people using the service, all of whom received 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
Risk and consent to care assessments were completed for people; however, some of the records included conflicting information. Medication administration records (MAR) and completion of observations did not always follow the provider’s policy nor best practice requirements. This could have placed people at risk of harm.
The provider’s statement of purpose was not up to date and they were signposted to the CQC website to review this. The provider had improved auditing and quality systems following the last inspection, however, there were still further improvements to be made. We found the provider’s policies were not always reflective of the service provided to people in their own homes.
We have made a recommendation for the provider to review their records and policies.
People and their relatives were positive about the service provided to them and the difference it made to their lives. One relative said, “They [the staff] attend, great continuity which is what we wanted. They have never let us down. They come in singing to [person], they are just lovely! They are a joy. Nothing is too much bother.”
People said they felt safe with the staff. Staff had completed a range of training courses and knew how to respond and keep people safe from harm. There were enough staff and safe recruitment had taken place. Infection control procedures and safe practice was evidenced. The provider demonstrated lessons had been learnt from past concerns.
People’s needs were assessed, and staff had the skills and knowledge to meet them. Staff supported people to access healthcare services and consulted with healthcare professionals as needed.
People told us staff were kind and caring towards them, and assistance was provided in an unhurried manner. Care records were kept securely, and people had access to information in their own homes.
People’s care records were person centred and provided staff with relevant personalised information. People and their relatives told us they were confident to raise concerns and felt action would be taken by the provider. End of life care training had been completed by staff.
People were positive about how the service was delivered and said they were involved in decisions surrounding their care. The provider promoted equality and diversity and was committed to treating people as individuals.
Staff told us they felt supported by the provider and contact had remained consistent during the COVID-19 pandemic. Staff had access to personal protective equipment (PPE), and people told us of the PPE staff used.
People were supported to have choice and control of their lives. Care was provided in the least restrictive way possible and in the best interests of people.
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 inadequate (inspection undertaken 28 and 30 October 2019. Inspection report published 16 January 2021). There were multiple breaches of regulation and the service was in Special Measures. The provider sent us an action plan to evidence how they met the requirements and communicated with us regularly following the inspection.
This service has been in Special Measures since November 2019. During this inspection (April 2021) the provider demonstrated improvements had been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. We carried out a comprehensive inspection.
Following our last inspection, we took urgent enforcement action to restrict any further care packages being delivered by the provider. We also required the provider to carry out a number of actions during the month of November 2019. We were provided with evidence of the actions completed which allowed us to monitor the quality of the service being provided to people. During this inspection we noted improvements had been made.
The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.
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.