Head Office

Updated 16 December 2022

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

One inspector undertook the inspection.

Service and service type

Head Office is a domiciliary care agency. This service provides care and support to people living in their own houses and flats, so that they can live as independently as possible.

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 that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 9 November 2022 and ended on 18 November 2022. We visited the location’s office on 9 November 2022.

What we did before the inspection

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 used information gathered as part of monitoring activity that took place on 8 June 2022 to help plan the inspection and inform our judgements. We reviewed the information we held about the service, including notifications we had received. Notifications are changes, events or incidents the provider is legally required to tell us about within required timescales. We sought feedback from the local authority. We used this information to plan the inspection.

During the inspection

We spent time with and spoke with three people, one relative, three members of staff, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. To help us assess and understand how people's care needs were being met we reviewed four people's care records. We also reviewed records relating to the running of the service. These included staff recruitment and training records, medicine records and records associated with the provider's quality assurance systems.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and care records. We spoke with a further one member of staff, two relatives and received feedback from two representatives from the local authority.

Updated 16 December 2022

About the service

Head Office is a domiciliary care agency which provides personal care to people living in their own homes. The service currently supports 19 people 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 our inspection there were seven people using the service who were in receipt of the regulated activity of personal care.

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

People told us they were supported by staff who were kind and caring and knew them well. People and their relatives told us the service was well managed and spoke highly of the registered manager.

People were not always protected by safe recruitment practices and systems operated by the provider had failed to identify shortfalls we found during this inspection. We have made recommendations in relation to management of risk, medicines, training, accessibility of information and end of life care.

Whilst the provider was not fully aware of all the concerns we identified, they were aware of the need to develop systems and processes to drive improvements and were committed to making those changes

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. Safeguarding systems were established and the provider had clear policies and procedures in relation to safeguarding adults.

People’s needs were assessed and care plans contained key information to inform and guide staff on how best to support each person. Staff seemed to know people well and understood how to communicate effectively with people and spoke about people in a dignified and respectful way.

Staff spoke positively about the leadership of the service and told us they felt listened to, appreciated and supported in their role.

The provider was keen to put processes in place to address any areas of concern or improve practice.

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 22 February 2021 and this is the first rated inspection.

Why we inspected

This was a planned inspection for a newly registered service.

Enforcement and Recommendations

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 monitor the service and will take further action if needed.

We have identified breaches in relation to recruitment and governance at this inspection. We have also made recommendations in relation to the management of risk, medicines, training, accessibility of information and end of life care.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.