Background to this inspection
Updated
6 August 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 and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
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. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave the service two days’ notice of the inspection. This was because we needed time for the agency to request permission from people for us to contact them by phone to gain their views of the service.
Inspection activity started on 8 July 2021 and ended on 15 July 2021. We visited the office location on 12 July 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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
We spoke with two people who used the service and five relatives. We e-mailed all staff to ask a range of questions, two staff replied to us. We visited the office location to see the registered manager and to review written records. We looked at two people's care records. We checked records relating to the management of the service including policies and procedures and quality assurance records.
After the inspection
We continued to ask for further information from the registered manager to validate evidence found.
Updated
6 August 2021
About the service
H & S Care & Medical Professionals is a domiciliary care agency which provides personal care to people living in their own homes in the community. 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 this inspection the service was providing personal care to 10 people.
People’s experience of using this service and what we found
Some improvements had been made since our last inspection which took place in August 2019. However, we found examples when records of care and support provided to people were not completed. Also, governance arrangements were not as effective or reliable as they should be. Further improvement was needed in the quality assurance processes to identify shortfalls and to drive improvement. Also, people who used the service and their relatives told us they had not been given the opportunity to give feedback to the service via a quality assurance process. We found no evidence people had been harmed however, systems were either not in place or robust enough to demonstrate safety was effectively managed. This could place people at risk of harm.
At the last inspection we found when people were first receiving the service, there were delays in care plans and risk assessments being made available in people's homes. This meant staff did not always have access to clear guidance to assist in the reduction of potential risks or to ensure people's care was managed safely. There had been times when staff had been expected to lift or move people without appropriate instruction in the use of people's equipment. This meant staff had had to rely on verbal instruction about people's needs and preferences.
At this inspection some improvements had been made. Although some people spoken with were not sure they had a care plan in their home, we saw evidence of detailed care plans and risk assessments in place. These set out the actions needed by staff to ensure people were cared for according to their assessed needs and wishes. Staff told us care plans and risk assessments were in people's homes and they were able to look at these and see where changes or updates had been made.
People spoken with who required assistance with moving and handling said they felt safe whilst being moved by staff. Relatives also said they had no concerns about the moving and handling of their family member. Staff told us they had received training in moving and handling people and healthcare professionals were on hand to give guidance and advice. People and relatives spoken with told us they felt safe whilst being cared for by the staff at H & S Care Professionals.
There were enough staff available to meet people's needs whilst adhering to the current restrictions due to the COVID-19 pandemic. The registered manager had managed the current COVID-19 pandemic well, although records of such things as staff testing were not fully completed.
People and relatives spoken with were very happy with the way staff had cared for them during the pandemic. They said staff always wore the appropriate Personal Protective Equipment (PPE) and had very high standards of personal hygiene.
People were happy with the quality of care and support they or their family member received. A small number of people told us newer staff could be better trained and visit times could be improved.
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 requires improvement (published 03 December 2019) and there was one breach of regulation.
At this inspection enough improvement had not been made and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.
Why we inspected
The inspection was prompted in part due to concerns received about the staffs understanding of COVID-19 protocols and guidance. A decision was made for us to inspect and examine those risks.
During this focused inspection we checked they had followed their action plan and checked 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.
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. 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 H & S Care & Medical Professionals 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 will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safe care and treatment and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.