Honeydew Healthcare Ltd

Updated 21 September 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by two inspectors and one member of the medicine team onsite. An Expert by Experience made phone calls to people and those important to them during the inspection. 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 houses and flats.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

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 27 June 2022 and ended on 29 July 2022. We visited the location’s office on 27 June 2022 and 5 and 20 July 2022.

What we did before the inspection

We reviewed information we had received about the service since they registered. We sought feedback from the local authority and professionals who work with the service. 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. We used all this information to plan our inspection.

During the inspection

We communicated with two people who used the service and six relatives about their experience of the care provided. We spoke with 10 members of staff including the registered manager. We reviewed a range of records. This included seven people’s care records and seven people’s medication records and related care records. We looked at four 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. We spoke with three health and social care professionals.

Updated 21 September 2022

About the service

Honeydew Healthcare Ltd is a domiciliary care agency providing personal care to people in their own homes. They provide this either in the form of regular visits to people or live in staff. People had a range of needs and some were more complex. 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

People and those important to them had mixed feedback about how well supported they were by staff. Some felt that they had very supportive, kind and caring staff led by a strong registered manager. However, others with more complex needs were less positive about their experiences.

Shortfalls were found with medicine administration and management including the lack of guidance for ‘as required’ medicine. Improvements were required to risk assessments to ensure consistent care in line with current best practice. Learning was starting to happen from things that went wrong, and systems were being developed.

Staff had a range of training and there was a drive to promote continual professional development. However, staff lacked skills to support people with more complex needs. This was reflected in gaps in training which could potentially lead to poor and unsafe practices by staff. Care plans often lacked the details and guidance for staff leading to a potential risk of inconsistent care and support being delivered.

People were supported to have choice and control of their lives. However, records did not always demonstrate how people were supported in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

The registered manager had a clear vision for the service and wanted to ensure people received the best care possible. However, systems to monitor the support being delivered not consistent and improvements were made during the inspection. This placed people at risk of harm and poor care.

End of life care plans had not been considered for every person receiving care at the service. Although, when people had expressed a wish not to talk about this it had been respected.

Following the inspection, the provider updated us on improvements that had already been made since the inspection.

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

This service was registered with us on 23 December 2021 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received following the outcome of a safeguarding investigation by the local authority safeguarding team. A decision was made for us to inspect and examine those risks. We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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 safe care and treatment, recruitment and governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.

We have also made a recommendation around decision making for people lacking capacity.

Follow up

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