We carried out a review of the data available to us about Help at Home Leicester 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 Help at Home Leicester, you can give feedback on this service.
Help at Home Leicester is a domiciliary care service. The service provides care and support to people living in their own homes. At the time of the inspection there were 517 people using the service.
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
Many people told us they would recommend the service to others. They told us they felt safe because they had confidence in staff’s ability to provide them with the support and care they need. Most people told us they were supported and cared for by staff who they were familiar with, and this contributed toward their feeling safe.
People’s safety was promoted by staff who followed guidance on how to reduce potential risk. People were supported by sufficient numbers of staff who had undergone a robust recruitment process. People were supported with their medicines. Staff training in key safety areas promoted people’s safety, which included staff knowledge and understanding of reporting potential safeguarding concerns, and following infection control procedures.
The provider had developed a contingency plan in response to Covid-19, and had adopted government guidance. People’s needs had been considered, and people and family members contacted to discuss their care during the pandemic. To reduce the potential spread of infection, paper-based information, including copies off rotas and surveys were no longer used. This meant all communications were via e-mail or phone.
People’s records detailed potential risks associated with their care, and provided clear guidance for staff as to how to minimise risk. Information was stored electronically, and all information about people’s needs was accessible to staff using hand-held devices. Staff updated records to detail the care and support as and when it was provided.
A few people expressed the service from office-based staff was not always timely, and communication could sometimes fall short of their expectations. This had been highlighted by the registered manager as an area for improvement, and personnel changes had been made to bring about improvement.
The provider was aware of their role and responsibilities in meeting their legal obligations. Systems to monitor the quality of the service were in place and were used to develop the service and drive improvement. Records were securely and accurately maintained.
Rating at last inspection
The last rating for this service was requires improvement (published 11 September 2019).
We carried out an announced comprehensive inspection of this service on 29 July 2019. A breach of legal requirements was found. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this focused inspection to check improvements had been made and that they now met the legal requirements. The inspection was also prompted in part due to concerns regarding the oversight and monitoring of the service. A decision was made for us to inspect and examine those risks. This report only covers our findings in relation to the Key Questions of Safe and Well-led.
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 Help at Home Leicester 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.
Help at Home (Leicester) is a domiciliary care agency providing personal care to people who live in their own homes. 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 546 people used the service to receive personal care.
People’s experience of using this service and what we found
The provider had systems and procedures in place to safeguard people from abuse. Where staff had not followed those procedures, disciplinary action was taken, and case reviews were carried out to reduce the risk of similar events happening again. A small number of people had experienced theft of valuables. Sometimes people had not had the required two care workers to support them.
People were supported by care workers who had the right skills and knowledge to provide care that met people’s assessed needs. 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.
Staff had not always followed procedures, for example letting the office know they would be late for a home care visit or, if they were one of a ‘double-up’ team, that the other staff had not arrived and that they had provided care and support alone.
People consistently told us that care workers were kind and caring and treated them with dignity and respect. A common concern that people shared with us was that they were not always informed when home care visits were running late. Some people experienced home care visits that were either too early or late which they found to be disruptive. People who required two staff to support them were sometimes supported by only one.
Most people experienced continuity of care because they were supported by a core team of care workers who understood their needs. Some people were yet to experience that continuity although the service’s performance in relation to that was improving.
The provider had procedures for monitoring the quality of the service which included seeking people’s feedback about their experience of the care and support they received. Most people were either very satisfied or satisfied with the care and support they experienced after staff arrived, but they were dissatisfied with punctuality of home care visits.
The service was in ‘transition’ and undergoing improvements to how home care visits were planned and monitored. Care records were being changed from paper to electronic format.
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 (report published 12/09/2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection improvements had been made, however improvements were still required.
Why we inspected
This was a planned inspection based on the previous rating.
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.
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 a service to adults in West Leicester, and in areas of Leicestershire such as Blaby, Oadby, Wigston and Market Harborough.
The CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where people receive this service, we also consider any wider social care provided.
The provider of Help at Home (Leicester) is Help at Home (Egerton Lodge) Ltd. The provider registered with the CQC in April 2017. This is the first inspection of the service since they became the provider for the service.
The service has a registered manager. 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 registered manager was registered with the service at the end of November 2017. They had an unexpected period of absence between January 2018 and April 2018, and returned to full time employment in June 2018.
The service has grown significantly in a relatively short space of time. The rapid growth was not fully supported by systems and processes which protected the quality of the service offered to people.
A lot of people received care calls at times which they had not agreed with the provider. They were either earlier or later than expected, and often they were not informed if the staff member was not going to be on time. Sometimes people did not receive their expected care call.
The office on-call and telephone response was not sufficient to ensure people’s safety. Often, people and staff could not speak directly to office staff; they might not be able to leave a message; and when messages were left, they were not always responded to.
People were not always safeguarded from harm because some staff had not followed safeguarding procedures and some were not clear about when to refer to the safeguarding authorities.
People were mostly very satisfied with the care workers who attended their calls. They told us the care staff were kind and helpful. They were less satisfied with the responses they received from office staff when they contacted about concerns or staff lateness.
Staff did not always follow safe medicine practice. This had been recognised by the provider and steps were being taken to improve and monitor staff’s practice.
The provider’s staff recruitment processes reduced the risk of recruiting staff unsafe to work in a care environment. There were not enough staff in the office to support office functions, and not enough staff to cover the care calls at the time people required them.
People thought staff had the skills and knowledge to support them in their care. Staff had mostly received training expected by the provider, but the training had not always supported staff to undertake their roles safely and effectively.
Staff understood the importance of people giving prior consent to care before any tasks were carried out. But some people told us staff did not ask their permission before undertaking care.
Not all people thought complaints were managed well, and the concerns and complaints we heard as part of the inspection, had not been documented and reflected in the complaints log at the service. Complaint records were poor.
People were satisfied with the support staff gave them with preparing meals and drinks; but some people were frustrated at the times they sometimes had to wait for staff to arrive to prepare them.
The provider had not given sufficient support to the service to support them to manage the growth of staff and people who used the service.
There had been a lack of staff direction and accountability. Senior management had recently started to provide support to the registered manager and their staff, to ensure all staff understood the expectations placed on them.