Background to this inspection
Updated
8 February 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 1 inspector.
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 we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 5 December 2022 and ended on 15 December 2022. We visited the location’s office on 5 December 2022.
What we did before inspection
We reviewed information we had received about the service since their registration. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We spoke with 4 people who used the service and 3 relatives about their experience of the care provided. We spoke with 7 members of staff including the registered manager, field supervisor, care co-ordinator and care workers.
We reviewed a range of records. This included 3 people’s care records and multiple medication records. We looked at records in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
Updated
8 February 2023
About the service
Sams Helping Hands Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and children with various needs including, physical disabilities and people living with dementia or a learning disability. At the time of this inspection 44 people were using the service.
Not everyone who used the service received personal care. The Care Quality Commission (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
People's medicines were not always safely managed. This was because guidance for staff was not always clear. This meant people were at increased risk of experiencing harm from avoidable medicines errors. Records for administering prescribed creams were incomplete. The service was not following the provider’s medicine policy in relation to ‘as required’ medicines. Medicine audit tools did not pick up on the discrepancies we found during the inspection.
Staff had not received specific training in relation to one person’s modified dietary needs. We have made a recommendation about provider revisiting the training needed in relation to modified diets, and ensures staff are confident and competent to apply their learning in their practice.
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; however, the systems in the service did not always support this practice. The provider had no specific mental capacity assessments in place. The registered manager implemented mental capacity assessments during the inspection process. We have made a recommendation about the provider reviewing their systems in place to work within the principles of the Mental Capacity Act (2005).
Care plans did not consider people's end of life wishes. We have made a recommendation about the provider reviewing their systems for people's end of life wishes.
The service did not always make statutory notifications to the CQC when required.
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 that 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.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. Care plans were person-centred and were focused on promoting people’s independency and empowering their lives. The care provided was person-centred and promoted people's dignity, privacy and upheld their human rights.
People were protected from the risks of abuse and staff were trusted to keep them safe. Staff had received training in how to safeguard people. Staff received training in infection prevention and control and told us Personal Protective Equipment (PPE) was readily available to them.
Recruitment checks were robust to ensure staff were suitable to work with vulnerable adults. The provider had systems in place to monitor staffing levels and ensure people received their visits. People told us staff were on time for their visits and if on an occasion staff were delayed, they would be informed.
People's needs were assessed prior to starting with the service and care plans were developed according to people’s needs. People and relatives were involved in their care planning. People’s views and decisions about care were incorporated when their care packages were devised. People were involved in making decisions about their day to day care. People’s independency was encouraged where possible and this was reflected in people’s care plans.
The registered manager and staff demonstrated a commitment to people, and they displayed person-centred values. The registered manager had regular contact with people. Relatives spoke positively about the registered manager. Staff praised the registered manager and wider management team, they felt supported in their roles.
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 17 March 2022 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about the provider’s recruitment processes. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern (please see the safe section of this full report). However, we have found a breach of another regulation. You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified a breach in relation to the effective management of medicines and good governance at this inspection. We have made recommendations in relation to staff training in modified diets, working within the principles of the Mental Capacity Act (2005) and people’s end of life wishes
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.