15 May 2014
During a routine inspection
As part of our inspection we spoke with both partners of the business (which included the registered manager) and the office manager. Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
We spoke with four people who used the service during our inspection who told us they felt treated with respect and dignity by staff at all times. People told us they felt safe and comfortable in the presence of staff. The service had systems in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had been submitted to the local authority. This means people were safeguarded as required.
The people we spoke with told us they usually had a regular carer, but that on occasions this changed if they were unavailable. Two people told us they were asked for their choice of either a male or female carer. Managers ensured people's care needs were taken into account when making decisions about the numbers, qualifications, skills and experience required for carers. This helped to ensure people's needs were always met.
We found medication practices were safe and thorough. Each person we spoke with told us staff administered their medication on time in line with their care package requirements. On the day of our inspection, some families were responsible for the administration of people's medication and others were the responsibility of staff. We visited one person in their own home and observed their medication being given. This was done in a dignified way and all necessary paperwork was then completed.
Is the service effective?
Initial needs assessments were conducted by the registered manager and were completed in conjunction with people who used the service and their families. Two of the people we spoke with told us they recalled staff visiting them or their families when their care package first commenced. Specialist dietary, mobility and equipment needs had been identified in care plans where required. We saw evidence care plans were reviewed on a regular basis with people's care requirements updated accordingly. This meant people's care needs could be amended if required to keep people safe.
People's houses had been checked and appropriately risk assessed to meet the needs of people with physical impairments. This covered things such as moving around the building, security, kitchen area and gas/electrics.
Is the service caring?
People were supported by kind and attentive staff. Comments from people included: 'I am well looked after by all the staff. They come in and make my meals for me' and 'I'm very happy. I like my regular carers. I have no concerns' and 'The care is very good. The girls assist me with showering, getting dressed and they make me a drink' and 'I feel safe. We have a laugh and they cheer me up'.
People's preferences, likes/dislikes and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. Risk assessments were in place and covered infection control, moving and handling, trips/fall and choking. We noted control measures were in place to keep people safe.
We spoke with a relative during our inspection who said: 'They are fantastic. They go above and beyond what X wants. They treat X well and I think X would be back in hospital if it wasn't for the care from the staff. I'm really happy and don't feel like I have to check up on what they are doing unlike other companies we have used'.
Is the service responsive?
There was a complaints procedure in place. People knew how to make a complaint if they were unhappy but had never been given reason to. People can therefore be assured that complaints are investigated and action is taken as necessary when required.
Systems were in place to ensure managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
There were other various quality assurance systems in place. These included the sending of regular surveys, observations of staff at work and regular supervision for carers where they were able to discuss issues effecting their work.
Is the service well-led?
Harmony Homecare is owned by two partners who also work closely alongside care staff in the community. In addition, there was an office manager and a mixture of senior care staff and general carers.
The service worked well with other agencies and services to make sure people received their care in a joined up way.
We asked if things such as team meetings happened regularly however we were told these had fallen behind and would be re-introduced following our inspection. This would provide further opportunities for staff to discuss concerns in order to improve the quality of service provided.