Big Hearts Recruitment Ltd

Updated 16 May 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors and 2 Experts 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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since their registration with CQC and sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also sought feedback from the local authority. We used all of this information to plan our inspection.

During the inspection

We visited the provider’s office where we spoke with the registered manager and 2 directors of the business. We also spoke with a care coordinator and met with 7 care workers with whom we held a group discussion. We also reviewed a range of records. Following the inspection, we spoke with 10 people and another 18 people’s relatives about their experience of the care provided. We also received feedback from a further 10 care staff. We sought feedback from 8 health and social care professionals and received a response from 1 of these.

Updated 16 May 2023

About the service

Big Hearts Recruitment is a domiciliary care service providing personal care to people living 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 there were 97 people receiving personal care. Four of these were receiving a live in care service.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People were not always 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 did not support this practice. Staff had not consistently completed comprehensive assessments of each person’s needs. Staff had not followed effective processes to assess and provide the support people needed to take their medicines safely.

Care was not consistently person-centred, and staff had not consistently assessed, monitored and managed risks. People did not consistently receive a reliable service that met their needs. Staff recruitment processes did not promote safety. Staff used personal protective equipment effectively and safely. Staff understood how to protect people from abuse.

Staff had not adequately evaluated the quality of support provided to people. Staff had received relevant training and underwent an induction which helped to ensure they understood their role and responsibilities. Staff spoke of a positive culture within the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 19 August 2021, and this is the first inspection.

Why we inspected

This was a planned inspection as the service had not previously been inspected.

Enforcement and Recommendations

We have identified breaches in relation to risk management, safety of medicines, governance and recruitment 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 to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.