UR Hands Care

Updated 20 May 2021

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 Care Act 2014.

Inspection team

The 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.

The service had a manager registered with the Care Quality Commission. The registered manager is the provider of UR Hands Care and will be referred to as ‘the provider’ throughout this inspection report. The provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

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

Inspection activity started on 12 April 2021 and ended on 22 April 2021. We visited the office location on 15 April 2021.

What we did before the inspection

We reviewed the information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

Before we visited the provider’s office, we spoke with two people who used the service and two relatives for their experiences. We also spoke with two care workers. We asked the provider to send us a range of records so that we could review these away from the provider’s office. Records included care plans, risk assessments, medication records and staff training and supervision records. Additionally, we requested some policies, the provider’s statement of purpose and other records relating to the management and oversight of the service.

When we visited the office, we spoke with the provider and the care manager. We looked at two staff files and checked whether the provider was displaying their rating from the previous inspection correctly.

After the inspection

Following the visit, the inspection continued, and we reviewed the records which were sent to us. We also spoke with one further staff member and a relative. We communicated with the provider and care manager so we could validate the evidence in the records.

Updated 20 May 2021

About the service

UR Hands Care is a domiciliary care agency providing personal care to people living in their own homes. The domiciliary care agency provides a service to older people, people living with dementia and people with physical disabilities. At the time of inspection there were three people using the service, all of whom received 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

Risk and consent to care assessments were completed for people; however, some of the records included conflicting information. Medication administration records (MAR) and completion of observations did not always follow the provider’s policy nor best practice requirements. This could have placed people at risk of harm.

The provider’s statement of purpose was not up to date and they were signposted to the CQC website to review this. The provider had improved auditing and quality systems following the last inspection, however, there were still further improvements to be made. We found the provider’s policies were not always reflective of the service provided to people in their own homes.

We have made a recommendation for the provider to review their records and policies.

People and their relatives were positive about the service provided to them and the difference it made to their lives. One relative said, “They [the staff] attend, great continuity which is what we wanted. They have never let us down. They come in singing to [person], they are just lovely! They are a joy. Nothing is too much bother.”

People said they felt safe with the staff. Staff had completed a range of training courses and knew how to respond and keep people safe from harm. There were enough staff and safe recruitment had taken place. Infection control procedures and safe practice was evidenced. The provider demonstrated lessons had been learnt from past concerns.

People’s needs were assessed, and staff had the skills and knowledge to meet them. Staff supported people to access healthcare services and consulted with healthcare professionals as needed.

People told us staff were kind and caring towards them, and assistance was provided in an unhurried manner. Care records were kept securely, and people had access to information in their own homes.

People’s care records were person centred and provided staff with relevant personalised information. People and their relatives told us they were confident to raise concerns and felt action would be taken by the provider. End of life care training had been completed by staff.

People were positive about how the service was delivered and said they were involved in decisions surrounding their care. The provider promoted equality and diversity and was committed to treating people as individuals.

Staff told us they felt supported by the provider and contact had remained consistent during the COVID-19 pandemic. Staff had access to personal protective equipment (PPE), and people told us of the PPE staff used.

People were supported to have choice and control of their lives. Care was provided in the least restrictive way possible and in the best interests of people.

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 inadequate (inspection undertaken 28 and 30 October 2019. Inspection report published 16 January 2021). There were multiple breaches of regulation and the service was in Special Measures. The provider sent us an action plan to evidence how they met the requirements and communicated with us regularly following the inspection.

This service has been in Special Measures since November 2019. During this inspection (April 2021) the provider demonstrated improvements had been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We carried out a comprehensive inspection.

Following our last inspection, we took urgent enforcement action to restrict any further care packages being delivered by the provider. We also required the provider to carry out a number of actions during the month of November 2019. We were provided with evidence of the actions completed which allowed us to monitor the quality of the service being provided to people. During this inspection we noted improvements had been made.

The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

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.