Helping Hands Plymouth is a domiciliary care agency. It provides personal care to people living in their own homes. It currently provides a service to older adults who need support with their personal care and/or have clinical healthcare needs. The service supports people within a 10 mile radius of Plymouth. The service is owned by Midshires Care Limited, who have 66 branches across the UK.Not everyone using Helping Hands Plymouth received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection there were 34 people receiving personal care.
The inspection was announced and started on 16 April 2018 and ended on 07 May 2018. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be available in the office. It also allowed us to arrange to visit people receiving a service in their own homes.
There was a registered manager in post. 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 provider had ‘values’ which underpinned staff practice and helped to form a positive culture. The regional manager told us “Our values of understanding, listening, excellence every time, building on success and a focus on people are really important to us”. Throughout our discussions with people and staff, we found these values to be embedded within the culture of the service.
There was a “no blame culture” adopted within the service, encouraging staff to be open and transparent when things had gone wrong, enabling learning to take place. This open and transparent approach demonstrated the providers understanding and recognition of the Duty of Candour. The Duty of Candour means that a service must act in an open and transparent way in relation to care and treatment provided when things go wrong.
Staff, were very much at the heart of the service. The regional manager told us, “We are nothing, without our staff”. Staff spoke positively of the provider’s supportive approach, and told us they felt financially rewarded for the work they did.
The provider welcomed and embraced feedback about their service, giving everyone access to their personal contact details within the staff handbook and service welcome pack.
There were robust systems in place to ensure the effective quality monitoring of the service. The provider’s governance policy set out the expectations of the registered manager to check the quality, of all aspects of the service, periodically. The registered manager also had access to a quality partner, who provided advice, guidance and support to help improve practices. When things went wrong, the provider reflected and used learning to help improve the service.
There was a supportive management structure in place for the registered manager which included regional management, area management and a quality partner.
The provider and registered manager kept up to date with changing practice and legislation. For example they were in the process of updating their consent policy in line with the new General Data Protection (GDP) legislation.
The provider worked in partnership with other agencies, to help ensure ongoing improvement and sustainability. Positive relationships were held with the local authority and commissioning teams.
People told us they felt safe. People were protected from abuse because staff received training in safeguarding, so therefore knew what action to take if they were concerned about someone being abused, mistreated or neglected. Staff, were recruited safely. Appropriate employment checks were carried out to help ensure staff were suitable to work with vulnerable people.
Staff told us they had sufficient time to provide people’s care and support, as well as adequate traveling time. The provider had emergency staffing procedures in place to help ensure people still received their care in times of staffing difficulties.
People’s risks associated with their care were monitored and managed well. People also had environmental risk assessments in place so staff, were aware of any hazards that could impinge on them delivering safe care.
People received their medicines safely. People’s health and social care needs were holistically assessed. People’s care plans supported staff to meet people’s individual communication needs.
People told us staff were competent and had the skills and experience to meet their needs. Staff, were complimentary of the training and support they received from the registered manager and provider.
People’s human rights were protected in line with the Mental Capacity Act 2005 (MCA), they were involved in making decisions relating to their care, and people’s consent to their care was obtained and detailed within their care plans.
People, when required, were supported effectively with their nutrition and hydration. Care records were in place to record people’s intake, when they were at risk of not drinking enough. The records enabled staff to monitor trends and to seek advice from health professionals, when necessary.
People had access to external health and social care professionals, and the service worked with external professionals to help ensure people’s care was co-ordinated.
People told us staff were kind and compassionate telling us, “I’m treated like a friend and they respect me”, and “I love them dearly”. Staff spoke fondly of the people they supported. The importance of having a caring ethos underpinning the service, formed part of the provider’s recruitment process, helping to ensure they recruited staff with a caring and empathetic demeanour.
Staff profiles were used to help people to make an informed choice about what staff they would prefer to support them, helping to ensure people were supported by staff with similar interests. This supported and encouraged meaningful conversations to take place during visits.
Helping Hands Plymouth is an organisation that recognised everyone an equal, regardless of their sexuality or ethnicity. Staff had received equality and diversity training and people’s individual needs were taken into account.
People told us their privacy and dignity was respected. Staff received training in respect of how to promote people’s dignity and privacy, and staffs understanding, was monitored by way of unannounced checks by managers.
People’s independence was supportively encouraged. People told us staff had a ‘can do’ attitude, and empowered people to do as much for themselves as possible.
People told us they received personalised care which met their individual needs. People’s care plans had been created by involving them and /or their family, and contained information about their health and social care needs.
People’s concerns and complaints were positively received and listened to. People, told us they felt comfortable to complain and when they had, prompt action had been taken.