We carried out a comprehensive inspection of Helping Hands Worthing on 31 January and 2 February 2018.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides support to older people and younger adults with physical disabilities, sensory impairments and mental health needs. At the time of the inspection 19 people were using the service.
This was the first inspection of the service since it was registered with the Care Quality Commission (CQC) in March 2016.
There was not currently a registered manager in post at 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.
The service had been without a formal registered manager since 6 January 2017. This had impacted negatively on the ability of the service to consistently deliver high quality care that met people’s needs. There was not always effective management of staff and quality assurance systems. This meant staff had not always had the right support and quality issues had not always been identified or acted on quickly enough. This is an area of practice in need of improvement.
People and their relatives said they thought the service was safe. The service had sufficient staff to meet people’s needs. There had been historical care co-ordination issues and the service had invested in resources to address this. We found that management of medicines was an area of practice in need of improvement.
People had risk assessments in place that identified any potential hazards to their well-being and the control measures needed. People were involved in this process and restrictions on their independence were minimised as much as possible. Accidents or incidents were reported internally and externally onto other relevant partner agencies for review and to agree any necessary actions to keep people safe.
There were systems and processes in place to keep people safe from abuse. Staff received equality and diversity training to have the skills to be aware of, recognise and take action to prevent people suffering from any form of discriminatory abuse.
There were safe recruitment practices. Staff induction training included infection control and food hygiene and staff followed these best practice guidance when supporting people with personal care and food preparation.
The service was operating within the principles of the Mental Capacity Act (MCA). People, or relevant people acting on their behalf, had consented to their care. People were involved in regular reviews of their support and could see their care plans whenever they wanted.
People’s physical, psychological and social needs were assessed to ensure the service was able to meet their preferred support outcomes. The service did not discriminate against people’s needs or decisions relating to their protected characteristics under the Equality Act 2010. Where necessary, people had effective support to meet their healthcare and eating and drinking needs.
Staff received sufficient on-going training and support to carry out their roles effectively. All staff received an induction that met the Care Certificate standards. The Care Certificate was introduced in April 2015 and is a standardised approach to training for new staff working in health and social care. It sets out learning outcomes, competencies and standards of care that care workers are nationally expected to achieve.
Everyone we spoke with told us they thought staff were caring. People were involved in making decisions about their care. Staff communicated with people in ways they understood.
Staff were compassionate and took steps to make people feel as if they mattered. People told us staff knew who they were as an individual. People’s privacy, dignity and confidentiality was respected and people were encouraged to be as independent as possible when having support.
The service took steps to protect people’s personal information in line with the principles of the Data Protection Act. These included having IT and other forms of security systems in place when collecting, sharing and storing people’s data.
People and relevant people in their lives were involved and had control over the planning and delivery of their support. People had personalised care plans that were reviewed regularly to ensure their needs were met and their choices were respected.
People’s care plans identified how to meet the communication needs of people with a disability or sensory loss. The service ensured the accessibility of information about care and support for people with a disability or sensory loss related communication need in line with the principles of the Accessible Information Standards (AIS).
There was a complaints policy in place and people told us they knew how to raise a complaint and felt confident to do so. Complaints were responded to and managed appropriately. Complaints were reviewed internally and used as a learning experience to help improve practice.
The provider sent staff and people surveys asking for feedback about the service performance and ideas about making it better and actions were taken based on their responses. Staff had support to maintain their personal well-being and their equality and diversity rights were respected and upheld in recruitment practices and organisational policies.
During this inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of this report.