The Old Mill

Updated 19 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 72 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 21 March 2023 and ended on 18 April 2023. We visited the location’s office on 5 April 2023.

What we did before the inspection

We used information gathered as part of monitoring activity that took place on 23 May 2022 to help plan the inspection and inform our judgements.

We reviewed information we had received about the service since they registered with the CQC. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We used technology such as telephone calls to enable us to engage with people using the service, relatives of people and staff, and electronic file sharing to enable us to review some of the documentation requested. We also reviewed documents during our visit to the office.

We spoke with 1 person and 4 relatives of people who used the service about their experience of the care provided. We spoke with 5 members of staff including the registered manager, and 4 care staff.

We reviewed a range of records using electronic file sharing and during our site visit. This included 3 people's care records and we looked at medication administration records. We looked at 3 staff files in relation to recruitment, and copies of right to work permits during our office visit.

We also looked at staff training, spot checks and staff supervision. A variety of records relating to the management of the service were also reviewed. This included safeguarding, incident and accident records, complaints, quality assurance processes, business contingency plans and COVID-19 policies.

After the inspection

The registered manager sent us examples of compliments received by a GP and friends and relatives of people who used the service. Formal feedback was provided to the registered manager on 18 April 2023.

Updated 19 May 2023

About the service

Haven Care Solutions – Main office is a domiciliary care agency providing personal care to people living in their own homes. The service provides support to people living with dementia, older and younger people, and people with physical disabilities. At the time of our inspection there were 5 people using the service.

Not everyone who used the service received the regulated activity of 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

Recruitment checks were carried out on potential new staff to the service, to help ensure they were safe to work with the people they supported. However, there were unexplained gaps in staff employment history. We also found improvements were needed to other recruitment documentation to make sure robust checks had taken place.

The registered manager had notified us of some but not all the safeguarding allegations they were legally required to. Quality audits were carried out to monitor the quality of the service provided, however the monitoring of staffs’ time keeping whilst actioned were not always formally recorded.

Staff had a good knowledge of the people they supported and had access to information in peoples' care plans and risk assessments. This information that helped guide staff to care and support people safely and effectively. However, these records could be more detailed to help reflect staffs’ knowledge and reduce the risk of impact to people if the staff member with knowledge left.

We have made a recommendation to the provider about improving the level of detail within people’s care records and risk assessments.

Not everyone needed medicines administration support from staff. Where this support was required, staff were trained to administer people’s prescribed medicines safely. Their competency to administer medicines in line with their training was checked by more senior staff. People fed back that staff were kind and respectful towards them. People told us there were enough knowledgeable and trained staff to meet their care and support needs. Staff understood how to keep people safe from poor care and harm. Staff confirmed that they would feel confident to whistle-blow any concerns they had to their registered manager or the CQC. Where people wanted to discuss their end of life wishes this information would be recorded to guide staff.

Staff told us they were trained in infection prevention and control and people confirmed that staff followed good practice guidance in relation to this. Systems were in place to learn lessons when an incident, accident or near miss occurred or there was a risk of this.

People, and their relatives had positive opinions on the communication of the office staff and management team. They told us the various ways staff requested feedback on the service. This included verbally during staff spot checks and via a survey. Staff were encouraged to discuss and review their performance through supervision and team meetings.

Staff encouraged people, where this level of support was required, to drink and eat plenty. People told us they were encouraged by staff to make their own choices and these choices were respected. Staff helped promote and maintain people's privacy and dignity. People gave examples of how staff did this. Staff also encouraged people to be as independent as possible. With the support from staff, people were able to remain in their own homes. Staff also encouraged people and their relatives, where appropriate, to be involved in discussions around their support and care needs.

The registered manager worked with external health and social care professionals. This helped people receive joined up care and support. There was a process in place to investigate and resolve complaints where possible. Actions were taken because of learning to try to reduce the risk of recurrence.

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.

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

Rating at last inspection

This service was registered with us on 28 October 2021, and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and recommendations

We have identified breaches in relation to staff recruitment checks and the legal requirement to notify the CQC of certain incidents at this inspection.

We have recommended the provider considered current guidance to update people’s care plans and risk assessments in more detail.

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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.