Archived: HICA Home Care - Hull

We carried out an unannounced comprehensive re-rating inspection of this service on 5 and 6 April 2016. This was to check that the registered provider now met legal requirements we had identified at inspections in December 2014 and October 2015.

Following our comprehensive inspection in October 2015 the registered provider was found to be non-compliant with regulations pertaining to providing safe care and treatment. During this re-rating comprehensive inspection we saw that the registered provider had taken appropriate action to ensure people were cared safely and that medicines were managed effectively.

Following our comprehensive in October 2015 the registered provider was found to be non-compliant with regulations pertaining to assessing and monitoring the quality of service provision. During this re-rating comprehensive inspection we saw that the registered provider had taken appropriate action; an internal review of the service’s day to day management and had taken action to ensure shortfalls in care and support would be identified in a timely way which enabled action to be taken promptly. Action plans to improve the service included realistic timescales and were monitored effectively to the completion. The internal review completed by the registered highlighted other areas that required improvements such as providing refresher training to staff and ensuring internal policies and procedures were reviewed at appropriate intervals and in line with current best practice and legislation.

Following our comprehensive in October 2015 the registered provider was found to be non-compliant with regulations pertaining to safeguarding vulnerable adults from abuse and improper treatment. During this re-rating comprehensive inspection we saw that the registered provider had taken appropriate action to ensure staff responded appropriately in emergency situations. Missed calls had reduced and a new call monitoring system had been implemented which highlighted when a call had not been attended at the allocated time. The service took action when staff’s action fell below expectable standards.

During the inspection we saw improvements had been made and have changed the rating for the ‘safe’ and ‘well-led’ domain from inadequate to requires improvement. However, we could not rate the service higher than requires improvement for ‘effective’, ‘caring’ and ‘responsive’ because to do so requires consistent and sustained improvement over time.

Staff received appropriate supervision and support from their line manager; they had completed relevant training and understood how to meet the needs of the people they supported. However, records showed staff did not receive refresher training in a number of areas which meant staff did not always have up to date skills and knowledge in relevant areas, such as fire safety, first aid, food hygiene and infection control. The registered provider’s training manager informed us that action was being taken to rectify this and staff would receive annual refreshers to meet their training needs. Some staff had not received an annual appraisal and we mentioned this to the registered manager. They acknowledged the issue and informed us that all outstanding annual appraisals would be completed by the end of April 2016.

This meant that the service was in breach of regulation 18 of the Health and Social Care Act 2008 [Regulated Activities] Regulations 2014. You can see a summary of the actions we have asked the registered provider to take at the back of the full version of this report.

Suitable numbers of staff who had been recruited safely were employed to meet the needs of the people who used the service. Risks identified during people’s initial assessment and on-going reviews were managed to mitigate the possibility of their occurrence.

Consent was gained before care and support was delivered and the principles of the Mental Capacity Act were followed. People we spoke with told us they consented to the care and support they received. People were supported to eat a diet of their choosing and staff encouraged people to eat healthily. When concerns were identified relevant professionals were contacted for their advice and guidance.

People told us they were supported by kind and caring staff who knew their preferences for how care and support should be delivered. People told us staff respected their privacy and dignity. Private and sensitive information was treated confidentially by staff who understood their responsibilities not to disclose it outside of the service.

People were involved with the initial and on-going planning of their care. Their levels of independence and individual abilities were recorded. The registered provider had a complaints policy which was made available to people who used the service. When complaints were received they were investigated in line with the policy and used to develop the service when possible.

Information was available for staff to follow to ensure people's needs were met. The response from the surveys we sent out was positive. People told us, 'The carers are really good they help me a lot,' 'They usually come on time, if they are going to be late the office rings me' and 'Now I have the same carer I'm happy.'

People who used the service were protected from the risks associated with medication because the provider had effective system in place to ensure their safety and wellbeing.

The provider had recruitment systems in place which protected people and ensured they were not exposed to staff who should not be caring for vulnerable people. Responses from the surveys we sent out indicated people felt safe and trusted the care staff.

People were able to have say about how the service was run and the provider had systems in place which audited the service provided to people.

Some people were very positive about the care provided by the service. They said that staff arrived on time, knew what they had to do to support them and carried out the care tasks efficiently. One person told us their main care workers were very good but improvements could be made when planning their replacements during holidays. Comments included, 'They do look after her well', 'I am very happy with service' and 'They involve me in what they are doing and I really appreciate that.'

We found that staff had received training in how to safeguard vulnerable people from abuse and they were aware of local safeguarding procedures. People told us they were provided with information about who to contact if they had any concerns.

People told us they would feel able to complain. They confirmed that when they had raised issues these had been addressed quickly to prevent them escalating into complaints.

We found that staff received training and support for their role and tasks.

We found that records were accurate and stored securely.