Archived: Hempstead House

Updated 24 October 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.

This inspection commenced on 6 August 2018 and was announced.

We gave the service 48 hours’ notice of the inspection visit because it is a domiciliary care agency and we needed to be sure that staff would be available to support the inspection process.

Inspection site visit activity started on 6 August 2018 and ended on 10 September 2018. It included speaking to people who used the service via telephone, contacting members of staff and seeking feedback from external health and social care representatives. We visited the office location on 16 August 2018 to see the manager and office staff; and to review care records and policies and procedures.

The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone using this type of service.

Before the inspection, we reviewed information available to us about the service such as information from the local authority, information received about the service and notifications. A notification is information about important events which the provider is required to send us. We also used information the provider sent to use in the Provider Information Return to inform our planning. 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 any improvements they plan to make.

During our inspection we spoke with nine people who used the service and one relative. We also spoke with three members of care staff, an administrator and the registered manager.

We looked at four people’s care records to see if they were reflective of their current needs. We reviewed three staff recruitment files and staff training records for all staff employed at the service. We also looked at further records relating to the management of the service, including complaints management and quality audits, in order to review how the quality of the service was monitored and managed.

Updated 24 October 2018

Hempstead House is a domiciliary care agency. It provides care and support packages including personal care to people living in their own houses and flats in the community across Hertfordshire. This part of the service was referred to by the provider as the outreach service.

Not everyone using the service receives 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.

This service also provides care and support to people living in a number of ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. The supported living schemes were located in Hertfordshire, London and Middlesex.

At the time of our inspection 53 people were being supported by the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager. A registered manager is a person who has registered with the CQC 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 using the service felt safe. There were systems in place to safeguard people from the risk of possible harm. Staff were aware of the risks to people’s health and well-being and ensured that risk management plans did not restrict the activities people engaged in. Personalised risk assessments were completed and updated regularly.

Accidents and incidents were reported and recorded promptly and action was taking to reduce the risk of reoccurrence. Any learning from any accidents or incidents was shared with staff.

People were supported with the prescribed medicines, where assessed as required. There were effective infection control procedures in place, with staff receiving training and being provided with personal protective equipment.

There were sufficient numbers of staff employed at the service who were effectively deployed to meet the needs of people in each scheme and the outreach service. The service had robust recruitment procedures in place.

Staff were knowledgeable and received training that provided them with the skills to meet people’s needs. Staff felt supported in their roles and received regular supervision and annual appraisals. These were consistently completed for all staff and were used to give feedback on performance and plan future personal professional development for staff at the service.

Staff were kind, helpful and maintained people’s dignity and independence throughout their care and support. Positive relationships existed between people and staff. Staff were knowledgeable about the people they were supporting and provided personalised care.

Assessment processes and care planning provided staff with the information they needed to support people effectively and meet their needs. People were involved in planning their care and deciding in which way their care was provided. Support plans were comprehensive and detailed people’s needs, preferences, background and history. People were supported to have maximum choice and control of their lives and the policies and systems in the service supported this practice.

People and staff knew who to raise concerns to and information regarding the complaints procedure was available. The provider had a consistent process for receiving complaints, concerns and feedback.

Quality assurance processes were in place. Regular audits were undertaken to assess the quality of various areas of the service. Feedback on the service was encouraged and people were provided with frequent opportunities to express their views on the care and support they received.

There was an open culture. People and staff found the registered manager and senior staff supportive and approachable.