We carried out a review of the data available to us about Harlestone Home Care Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Harlestone Home Care Ltd, you can give feedback on this service.
Harlestone Home care is a domiciliary care service providing personal care and support to people in their own homes. At the time of the inspection there were 16 people receiving support.
Not everyone who used the service received 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
The systems in place to monitor and quality assure the service had not always been maintained. The provider had not consistently maintained the level of oversight required.
People felt safe and cared for by the staff who supported them and who knew them well. Staff knew how to keep people safe and ensured people received the care they required at the time they wanted.
People could be assured they were being cared for by staff who were recruited safely and who had the skills and knowledge to support them. Infection prevention and control measures were in place and staff knew how to administer medicines safely.
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; the policies and systems in the service supported this practice.
The care people received was person-centered. People had been involved in planning their care and felt able to speak up if they had any concerns or wished to make changes to their care.
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 6 February 2020) and there was a breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 28 November 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve receiving and acting on complaints.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Harlestone Home care Ltd on our website at www.cqc.org.uk.
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.
Harlestone Home Care Ltd is a domiciliary care agency providing personal care and support to 29 people in their own houses and flats.
Not everyone who used the service received 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
Complaints had not been recorded. One person had made a complaint that had not been recorded and responded to in line with provider’s policy and had resulted in legal action. Another person’s verbal complaint had not been recorded but they told us they had received a verbal response. Following the inspection, the registered manager implemented a system for recording monitoring and responding to complaints.
People and staff told us that the service was currently short staffed. This had not impacted on the safety of people or staff, but people told us they were not always getting their calls at their preferred times and they weren’t always told by the office team which staff members would be visiting them. The registered manager had a contingency plan which deployed trained office staff to cover care staff shortages.
The registered manager had not consistently maintained oversight of training with some training refreshers now overdue. Staff supervisions had not been completed as per the providers policy. However, these issues had been identified prior to our inspection and systems had been implemented to improve oversight, this would now need to be continued and embedded in practice. Staff received an induction and thorough training prior to working with people.
People were assessed prior to starting with the service. Their religion, culture, likes dislikes and choices were all considered and planned into care. People had personalised risk assessments in place and told us that staff listened to their choices and preferences. Some people could not recall having a review of their care, records showed regular updates were in place. The registered manager felt that this was because reviews are kept friendly and informal to put people at ease. We have made a recommendation around ensuring people are aware when reviews and updates are taking place.
Systems and processes protected people from the risk of abuse. Staff had a good understanding of the whistleblowing procedure and how to keep people safe. Incidents and accidents were recorded, monitored and actioned appropriately.
Medicines were managed safely with regular audits taking place. People told us they got their medicines when they needed them. People were protected from the spread of infection. Risks to people were assessed and planned into care delivery.
Staff had developed good relationships with people and people found them to be kind, caring and respectful. People were well supported with eating and drinking where needed. The staff and management team worked in partnership with other professionals to ensure people were supported with their health and social care needs in a timely manner.
People’s communication needs were considered, and information could be made available for people in easy read pictorial and other languages when required.
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; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 25 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified a breach of regulation in relation to receiving, recording and acting on complaints.
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 for the provider to understand what they will do to improve. 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.
There was a registered manager in post who was also the provider of the service. 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.
Recruitment procedures required strengthening to ensure that staff had been subject to the appropriate pre-employment checks prior to providing care to people without supervision.
People were safeguarded from harm as the provider had effective systems in place to prevent, recognise and report concerns to the relevant authorities. Staff knew how to recognise harm and were knowledgeable about the steps they should take if they were concerned that someone may be at risk.
People’s care records contained risk assessments and risk management plans to mitigate the risks to people. They gave information for staff on the identified risk and informed staff on the measures required to minimise any risks.
People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005. Staff provided people with information to enable them to make an informed decision and encouraged people to make their own choices.
Staff had a full understanding of people’s support needs and had the skills and knowledge to meet them. Training records were up to date and staff received regular supervisions and appraisals. Staff were clear about their roles and responsibilities in caring for people and received regular support from the provider.
Staff were vigilant regarding people’s changing health needs and sought guidance from relevant healthcare professionals.
People’s needs were met in line with their individual care plans and assessed needs. Staff took time to get to know people and ensured that people’s care was tailored to their individual needs.
People had the information they needed to make a complaint and the service had processes in place to respond to any complaints.
People were supported by a team of staff that had the managerial guidance and support they needed to carry out their roles. The quality of the service was monitored by the audits regularly carried out by the provider who was also the registered manager.