Harmony Care - Little Bloxwich Community Hub

Harmony Care- Little Bloxwich Community Hub is a domiciliary care service providing personal care to 46 people across Walsall at the time of the inspection. People were supported within their own homes, flats or supporting living accommodation.

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

We found a lack of recorded best interest decisions for people who lacked capacity.

Relatives and people told us they felt safe with the staff who supported people.

Staff had regular safeguarding training and knew about the different types of abuse. Staff understood their responsibilities in relation to protecting people from the risk of harm. Where risks to people had been identified, risk assessments were in place with clear instructions on how to protect people.

People were supported by staff who were well trained and competent in their role. People were assessed before they used the service to ensure their needs and preferences could be met. Staff liaised with other health care professionals to ensure people's health care needs were met safety. Staff were very knowledgeable about people's changing needs and supported people with their medicines when they needed them.

Staff understood the importance of ensuring people's rights were understood and respected. People told us they felt well cared for by staff and this was confirmed by relatives. People told us staff treated them with respect and dignity and encouraged them to maintain relationships and independence.

People's communication needs were assessed and understood by staff. People were provided with information in a format which met their needs.

Staff spoke positively about working for the provider. They felt well supported and they could talk to management at any time. They felt confident any concerns they raised would be acted upon promptly. They felt valued and happy in their role.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were working towards consistently meeting the underpinning principles of Right support, right care, right culture.

Right support:

People were supported to be independent and have choice and control. Improvements are required to ensure best interest decisions are recorded.

Right care:

Care was delivered in a way which meant people's human rights were respected.

Right culture:

Harmony Care were working with management and staff at all levels to continually improve the culture of the service. Staff were aware of the organisations visions and values which were centred around supporting people to live meaningful lives.

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 requires improvement (published 26 February 2020).

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 16 December 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We received concerns in relation to the management of safeguarding incidents, the administration of medicines and the management of quality assurance processes. As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

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.

Harmony Care- Little Bloxwich Community Hub is a domiciliary care service providing personal care to 72 people across Staffordshire and Walsall at the time of the inspection. People were supported within their own homes, flats or supporting living accommodation.

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

People were not supported to receive their medicines safely and staff were not always recording the support they had given people with their medicines.

People were not supported to remain safe. The provider had failed to ensure all potential incidents of safeguarding had been reported and investigated to reduce the risk of reoccurrence.

People were not supported in a timely way by a regular staff team who knew them well. People felt rushed and had to wait for their support.

People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests as people’s capacity had not always been assessed.

People were not supported by a staff team who had up to date training and were always recruited safely. The provider had failed to consistently act upon people's complaints to drive improvements at the service.

People were not always supported to eat and drink in a safe way. People were not all supported in a caring way which respected their dignity as people had to wait for care.

People did not have care plans which contained clear guidance for staff to support them to meet their needs. People did not have regular reviews of their care to ensure their support met their changing needs.

The service didn’t always apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people did not fully reflect the principles and values of Registering the Right Support as people’s needs had not been reviewed to ensure staff offered support in line with these and in a way which people preferred.

The provider had failed to ensure quality assurance tools were in place and effective at identifying, implementing and sustaining improvements at the service. The provider had not ensured people were able to give feedback about their care and lessons were learned when things went wrong.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

Since the last inspection the service has changed its name. We have used the service’s previous rating to inform our planning at this inspection. The last rating for this service was requires improvement (published 07 September 2018). Since this rating was awarded the service has moved premises. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

The inspection was prompted in part due to concerns received about people receiving safe care, staff training and there not being sufficient staff to meet people’s needs. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to people receiving safe care and treatment; people’s capacity being assessed and best interest decisions being recorded; safeguarding incidents not all being reported to the local authority safeguarding team; people’s care calls being late and missed; complaints not being recorded and acted upon to drive improvement and the governance at the service.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.