We carried out a review of the data available to us about Mrs O's Caring Hands Homecare Limited 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 Mrs O's Caring Hands Homecare Limited, you can give feedback on this service.
Mrs O’s Caring Hands Ltd - Northumberland Office is a domiciliary care service providing personal care to adults. 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. At the time of our inspection there were 65 people receiving support.
People’s experience of using this service and what we found
People and relatives spoke positively about the caring nature of staff. Comments from relatives included, “When they come into my home they come in as new friends” and “They are so patient, they don’t rush her or try and tell her what to do. One lady [staff] came in with treats for my dog.”
People were safeguarded against the risk of abuse. People told us they felt safe with the staff who supported them.
Recruitment had been affected by COVID-19 and the current cost of living crisis. The provider had reduced the areas they covered to ensure they had enough staff to cover people’s needs. People and relatives told us that they usually saw the same team of staff who knew their needs.
People and relatives told us that staff wore PPE to help reduce the risk of infection.
There was a system in place to manage medicines. We identified several issues relating to the recording of medicines which the registered manager told us would be addressed. We have made a recommendation that the provider reviews best practice in relation to medicines management and reiterates this to staff to ensure this is followed.
The provider used an electronic rostering and monitoring system. There had been a cyber-attack in August which was not due to any fault of the provider; however, this had caused several missed calls. The provider had introduced temporary new management and recording systems until the IT system was fixed.
Audits were carried out to monitor the quality and safety of the service. The provider was strengthening their assessment and monitoring of medicines management. Whilst we understood the impact which the cyber-attack had upon the service; we did identify several shortfalls in relation to the maintenance of records relating to people who required specialist feeding techniques and the use of certain medical equipment. The registered manager told us this would be addressed immediately.
Most people and relatives thought the service was well managed. Comments from relatives included, “It is very well managed and well organised. They have been round to introduce themselves” and “They have done everything they need to do, when they need to do it. I would definitely recommend them.” Some people told us they felt that communication could be improved since they did not always know who was coming to support them. We passed this information to the registered manager who explained that the recent cyber-attack had impacted upon their recent communication and rostering abilities; however this had been addressed.
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 requires improvement (published 9 December 2020).
Why we inspected
We carried out a focused inspection of this service in November 2020. A breach of legal requirements was found in relation to medicines management. The provider completed an action plan after the last inspection to show what they would do and by when to improve in this area.
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 and well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. 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 Mrs O's Caring Hands Homecare Limited on our website at www.cqc.org.uk.
Recommendations
We have made a recommendation in the safe key question in relation to medicines management. Please see this section for further details.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Mrs O’s Caring Hands Homecare Limited is a domiciliary agency providing personal care to people living in their own homes throughout Northumberland. Services were provided to adults with a wide range of health and social care needs including physical disabilities, mental health needs and those living with dementia. At the time of our inspection there were 86 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
Medicines management procedures needed to be improved. We were not assured that people either received their medicines in a timely manner or as prescribed.
There were quality assurance systems in place to monitor the service and care being provided. Some records and quality assurance processes would benefit from further review. We have made a recommendation regarding this.
There were enough suitably recruited staff on duty although an update in recruitment procedures was required. We have made a recommendation regarding this.
Safeguarding procedures were embedded within the service and incidents and accidents were reported and investigated. Recording systems were being reviewed.
Staff were kind and caring and the registered manager was praised by staff for their support. There was evidence of a supportive culture throughout the management and office teams.
Infection control procedures were being followed and any issues arising were addressed straight away. Enough masks, aprons and gloves were available for staff to use.
People and staff reported that the service was well led. We did receive some mixed comments on communication within the office team which was raised with the management team to look into.
People had the opportunity to feedback on their experiences, but it was not always clear if action had been taken. We have made a recommendation in connection with this.
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 21 December 2017).
Why we inspected
We received concerns in relation to the management of medicines, staffing, unsupportive culture and quality assurance. As part of CQC's response to the coronavirus pandemic, we are also included a review of infection control and prevention measures as part of this inspection. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.
Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe and well led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mrs O’s Caring Hands Homecare Limited on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We have identified a breach in relation to safe care and treatment at this inspection.
Please see the action we have told the provider to take at the end of this report.
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.
Mrs O’s Caring Hands is a domiciliary care provider based in the Blyth, providing personal care to people in their own homes in the local area. At the time of our inspection the service provided personal care to 21 people, the majority of whom required help to maintain their independence at home.
The service had a registered manager in place. 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. The registered manager had extensive experience of working in the social care sector, as did their training manager, who supported them in the running of the service.
People who used the service told us they felt safe and relatives, along with external professionals, expressed no concerns regarding safety. Staff had received safeguarding training and were confident in how to identify and report potential sources of abuse.
Risk assessments were in place to ensure people were protected against a range of harms. These were sufficiently detailed and regularly reviewed and staff displayed a good knowledge of the risks people faced.
Pre-employment checks of staff were in place to protect against the risk of unsuitable people being employed.
A lone worker policy and procedures were in place, with an out-of-hours contact telephone number and personal attack alarms provided.
Medicines administration was regularly audited and staff were trained appropriately; we found no evidence of medication errors. The medication policy and safeguarding required updating and the registered manager did this the day after our inspection.
There were sufficient staff, effectively deployed, to meet people’s needs safely, with travel time included in the planning of care calls.
Staff were trained in core areas such as first aid, person-centred care, moving and handling, safeguarding and dementia. Additional training was provided where required.
Staff had a good knowledge of people’s likes, dislikes, preferences, mobility and communicative needs. People who used the service confirmed staff knew them well.
People who used the service were supported to maintain their independence in their own homes, in line with the service’s literature.
Care plans were sufficiently detailed and person-centred. They gave staff relevant background information and detailed care information about people, meaning care was individualised.
Care plans were reviewed regularly and with the involvement of people who used the service and their relatives.
Staff displayed a good understanding of capacity and the need for consent on a decision-specific basis. People confirmed their consent was sought at each care visit. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People we spoke with and relatives told us they had received positive outcomes when suggesting changes or raising queries, for instance requesting a specific carer or changing a call time.
People told us they knew who to contact if they had concerns and the provider’s complaints policy was readily available in the files people had in their home.
We saw there were a range of audits and other quality checks to identify errors, inconsistencies, or scope for improvement.
Staff, people who used the service, relatives and other professionals were in agreement that the registered manager led the service well. We found them to have a good knowledge of the needs of people who used the service, and had a clear vision for how the service could grow in the future, whilst maintain good standards of care for people who used the service.
The registered manager, training manager and staff had successfully established a caring culture, where care could be delivered in a calm, patient manner that had regard to people’s individualities.