Heathbank Support Services

Heathbank Support Services is a domiciliary care agency ran by a small charitable organisation in Oldham. The service provides personal care to people with a learning disability or autism living in their own houses and flats. At the time of this inspection 6 people were using the service.

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.

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 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.

Right Support:

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. People received flexible support and they could adapt their daily support to suit their needs and choices. Staff supported people to play an active role in maintaining their own health and wellbeing . We have made a recommendation about the provider reviewing the frequency of staff medicine competency assessments.

Right Care:

People received kind and compassionate care. Staff understood and responded to people’s individual needs. Staff understood how to protect people from poor care, abuse and harm. The provider had robust safeguarding systems in place. Staff had training on how to recognise and report abuse and they knew how to apply it. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual needs.

Right Culture:

Staff placed people's wishes, needs and rights at the heart of everything they did. The registered manager evaluated the quality of support provided to people, involving the person and their families as appropriate. Managers ensured risks of a closed culture were minimised, so people received support based on transparency, respect and inclusivity. We have made a recommendation about the provider reviewing their auditing processes.

People told us they felt safe and knew how to raise concerns. The registered manager and staff assessed health and safety. There were enough staff to meet peoples' needs and recruitment processes were ensured staff were suitable to work with vulnerable people. People received consistent support from staff who knew them well. Staff worked with health professionals to support people's health needs.

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

Rating at last inspection

The last rating for this service was good (published 4 April 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Recommendations

We have made recommendations about the provider reviewing the frequency of staff medicine competency assessments and reviewing their auditing processes.

Follow up

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

Heathbank Support Services is a small charitable organisation based in Oldham. The service provides personal care and support to enable people to live as independently as possible within their own home. The service provided personal care to seven people at the time of our inspection.

People’s experience of using this service:

People and relatives were very positive about the service and gave numerous examples of kind and caring practices.

The staff we spoke with had a good understanding of the people they supported and knew how to provide appropriate support.

People were fully assessed, and care records contained information about people’s needs, abilities and preferences.

There were risk assessments in place which were detailed and specific to the individual.

There were suitable systems in place to recruit staff safely.

Staff received the training they needed to support individuals with their specific health and social care needs.

The service worked closely with other health care professionals and supported individuals to access appropriate health care services when needed.

People, relatives and staff felt able to raise concerns with the registered manager and felt these were addressed quickly and effectively.

People, families and healthcare professionals were invited to regular review meetings to ensure care plans remained appropriate and relevant.

The service had developed a number of systems to improve oversight and governance within the service. Paperwork was regularly reviewed by the registered manager to ensure it was up to date.

The service had various strategies for improving practice and sharing learning, including networking with other services and an active committee board to whom the registered manager reported.

Rating at last inspection:

At the last inspection the service was rated as Good (13 September 2016).

Why we inspected:

This was a planned inspection to check that this service remained Good.

Follow up:

We will continue to monitor this service and plan to inspect in line with our re-inspection schedule for services rated Good.

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

We last inspected Heathbank Support Services in October 2015, when we undertook a comprehensive inspection. During this inspection we found the provider was in breach of five regulations of the Health and Social Care Act (Regulated Activities) Regulations 2014. These breaches were in relation to: The safe management of medicines. Care planning was not always coordinated to ensure the health, safety and welfare of people. Care provided did not always meet the individual needs of people and reflect their preferences. Consent was not always sort in line with legislation particularly in relation to covert medication. Governance systems and processes were not effective to ensure the delivery of safe, quality care. There was insufficient numbers of suitably qualified, competent, skilled and experienced staff to meet the needs of people being supported. The provider had to send us a report detailing what action they were going to take. The service was rated inadequate overall, which meant that it was placed into “Special measures.” During this inspection we found significant improvements had been made.

Heathbank Support Services provides care to people in their home. Since our last inspection the registered manager of the service had changed and a new registered manager was in post.

Heathbank Support Services is required to have a registered manager in post. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like the registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the health and Social Care Act 2008 (Regulated Activity) Regulations 2014 about how the service is run.

Heathbank Support Services is a small charitable organisation based within the Oldham, Greater Manchester area. The service provide personal care and support to enable people to live as independently as possible within their own home and supported living accommodation. At the time of our visit, Heathbank was providing a Domiciliary Care Service to 8 people living independently within the community and support to 5 people Living in Supported Living Accomodation. All 13 people had a range of health and social care needs.

We found the contents of care records we reviewed were detailed and contemporaneous. The care records contained information to demonstrate that potential risks to people’s health and wellbeing had been fully assessed, monitored and managed.

Appropriate arrangements were in place to ensure the proper and safe management of medicines. All care workers had been trained to administer medicines to people.

Care workers were recruited safely and appropriate training was provided to enable them to carry out their role effectively and care for people safely.

Care workers were able to demonstrate their understanding of the whistle-blowing procedures and they knew what to do if an allegation of abuse was made to them or if they suspected that abuse had occurred.

Relatives of people using the service spoke warmly about the care workers. We saw that the relationship between people and their support worker’s on the day of the inspection was good. We saw people were happy with the care and support they received and spoke positively of the kindness and caring attitude of the care workers.

We found that people using the service and their relatives were involved in making decisions about their care. Care was being planned and delivered to ensure it met the individual needs and preferences of people who used the service.

All systems and processes had been updated to reflect current care practices. Records were being effectively stored, monitored or maintained.

The new management encouraged a positive culture amongst care workers. Care workers spoke positively about the changes in atmosphere and a more approachable management team.

All policies and procedures had been updated.

Care workers had received regular support to enable them to carry out their role and responsibilities effectively.

We saw that people were settled and comfortable. People recognised staff and we saw that relationships were established and positive. There was a good rapport with people and staff spoke with people in a respectful manner.

We spoke with two representatives of people who the agency supported. They spoke positively about the staff supplied by Heathbank Support Services. One person said that staff adapted their approach to the different needs of people who required support. Another representative said when there were issues the manager of the agency responded to these.

The three support staff we spoke with demonstrated a good understanding of providing individual support to people. Staff told us how they promoted people's rights to privacy and dignity by using appropriate communication methods and respecting people's wishes. They confirmed they had received training for infection control and used protective clothing such as gloves and aprons to minimise the risk of cross infection.

We saw that staffing numbers were monitored and people were asked for their feedback about the service they received.

We spoke with three relatives who were representatives for people who received care and support from the agency. We heard comments such as 'Absolutely wonderful'; 'I have no concerns about the quality of care' and 'They [the staff] are brilliant with [my relative]". The relatives we spoke with confirmed that there was good communication with the agency. We heard that people were confident that any concerns they raised would be dealt with promptly.

Health and social care professionals said 'They [the agency] provide an excellent service' and 'We have no concerns about the care provided. They [the staff] communicate very well'.

We saw that people's health and wellbeing was assessed at least monthly and people's representatives and other professionals were consulted as required. Records provided evidence that people's preferences were taken into account during the planning of their care.

We saw that records were up to date. Robust recruitment procedures were in place and staff did not start work until all the appropriate checks were completed. Records showed that staff received appropriate training and regular individual support.