Background to this inspection
Updated
12 June 2021
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 Care Act 2014.
Inspection team
The inspection was carried out by two inspectors and two 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 homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
The inspection was announced.
We gave the service three working days’ notice of the inspection visit. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection visit, and we began inspection activity the day before the inspection visit, such as calling staff and reviewing records remotely.
Inspection activity began on 5 May 2021 and ended on 7 May 2021; the office visit was carried out on 6 May 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with 20 people who used the service and 10 relatives about their experience of the care provided. We spoke with 13 members of staff including the registered manager, the supporting manager, the training manager and 10 care workers.
We reviewed a range of records. This included 15 people’s care records and five medication records. We looked at six staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
12 June 2021
About the service
Extra Hands of Heacham Limited is a domiciliary care service. They provide personal care and support 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 the service was providing the regulated activity to 140 people, 34 of whom were supported with medicines.
People’s experience of using this service and what we found
The provider had not developed full, accurate contemporaneous records relating to all relevant aspects of people’s care. This included full records with guidance and risk assessments around people’s needs, health conditions and medicines. They were developing a new electronic care planning system to include all areas of people’s care.
Improvements were needed around the recording and administration of people’s medicines.
People received care from staff who were knowledgeable about the risks associated with people’s care and received effective training related to keeping people safe, including managing risks associated with their health and safeguarding people from harm.
Staff were recruited safely and cared for a consistent group of people they knew well. People received a responsive, person-centred service from competent and caring staff, and they knew how to raise concerns.
There were infection control measures in place which contributed to protecting people from, and managing risk of infection, including from COVID-19. This included staff wearing full personal protective equipment (PPE) during care visits.
There was a strong positive working culture in the service and good teamwork amongst the staff. People, their families and staff felt involved in the ongoing service delivery and were informed about changes.
We have made two recommendations in relation to care planning around risk and end of life.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 02 October 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
This was a focused inspection to look at Safe, Responsive and Well-led. This report only covers our findings in relation to these three key questions. We have found evidence that the provider needs to make improvements. Please see the well-led section of this full report.
We found no evidence during this inspection that people were at risk of harm from this concern. You can see what action we have asked the provider to take at the end of this full report.
We reviewed the information we held about the service and no areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Extra Hands of Heacham Limited on our website at www.cqc.org.uk.
Enforcement
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 have identified a continued breach in relation to good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.