Harvest Life Care Ltd

Updated 3 August 2018

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 is 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.

The inspection took place on 21, 22 June, 4 and 5 July 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 21 June 2018 and ended on 5 July 2018. It included visiting the office and speaking to staff, people who use the service and their relatives by telephone. We visited the office location on 21 June and 4 July 2018 to see the registered manager and office staff; and to review care records and policies and procedures.

The inspection was undertaken by one inspector and an assistant inspector.

Prior to the inspection we used information the provider sent us in the Provider Information Return on 6 April 2018. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and the improvements they plan to make. We reviewed other information we held about the service to aid with our inspection planning. This included past inspection reports and notifications. A notification is information about important events which the service is required to send us by law.

We also contacted other health and social care organisations such as representatives from local authority contracts teams; Healthwatch, the local safeguarding authority and a representative from the discharge planning team at a local hospital. This was to ask their views about the service provided. Their views helped us in the planning of our inspection and the judgements we made.

We spoke with two people and three relatives of people who used the service. We spoke with the registered manager; nominated individual; an external consultant employed by the service; the deputy manager and four support workers.

We looked at care documentation for three people, medicines records, three staff recruitment files, staff supervision, appraisal and training records. We also looked at other records relating to the management of the service including audits and action plans; accident and incident records; surveys; meeting minutes; complaint and compliment records. We also looked the service user guide, the statement of purpose, equality and diversity policy, the end-of-life policy, bathing and showering policy and the complaints policy.

Updated 3 August 2018

Harvest Life Care Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to 15 older adults and younger disabled adults. This includes a 'live in' care workers service (this means that there are staff supporting some people 24 hours a day, seven days a week).

This inspection took place on 21 and 22 June, and 4, 5 July 2018. The inspection was announced. This is the first Care Quality Commission (CQC) inspection since the service registered on 2 June 2017.

Not everyone using Harvest Life Care Ltd received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager in place. 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.’

People sometimes experienced late care calls or care calls at a different time to times agreed. We have made recommendations that the provider has a robust system in place for monitoring call times and duration which would help to identify and manage any late or missed calls to people more effectively.

Staff were not always following the providers medication policy. They were not providing to people the agreed level of support they needed to take their prescribed medication safely. This meant people were not always having their medication as prescribed. We have made recommendations that the provider consider current guidance such as NICE guidance on managing medicines for adults in community settings (March 2017) and take action to update staff practice accordingly.

People were supported by staff who knew about safeguarding and its reporting processes. Risk management strategies provided guidance and information for staff on how to reduce and monitor people’s assessed risks to their health and welfare. People’s care records were held securely within the office to ensure confidentiality and a copy held within people’s own homes.

People had technology and equipment in place to help staff assist them to receive safe care and support. When things did not go as planned, the registered manager took actions to reduce the risk of recurrence.

Staff were inducted and trained to meet people’s care and support needs. Supervisions and competency checks were in place to monitor and develop staff. New staff had recruitment checks completed on them prior to them working at the service.

Systems were in place for staff to maintain infection prevention and control.

People were involved in their care decisions and staff promoted people’s independence as far as practicable. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were assisted by staff, where needed, with their eating and drinking to promote their well-being.

Staff worked with other organisations to provide care that was coordinated and joined up. Where people were at the end of their life staff worked in partnership with other healthcare professionals to ensure their care was dignified and comfortable.

People received a caring service by staff who knew them well. Staff maintained people’s privacy and dignity when supporting them with their personal care needs.

Compliments were received about the service and people were happy with how their complaints were managed, responded to and resolved where possible. The registered manager led by example and encouraged an open and honest culture within their staff team. Audit and governance systems were in the process of being improved so that they could identify and drive forward any improvements required. The registered manager and their staff team linked up and worked with other organisations to ensure people’s well-being.

Further information is in the detailed findings below.