Care at Hand Limited

Updated 27 February 2024

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.

Inspection team

The inspection was completed by 1 inspector and an Expert 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 houses and flats, and specialist housing.

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 25 September 2023 and ended on 29 September 2023. We visited the location’s office on 25 September 2023.

What we did before the inspection

We reviewed information we had received about the service since the service was newly registered. We sought feedback from the local authority 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 spoke with 3 people who use the service and 4 relatives about their experience of the domiciliary care service. We spoke with the nominated individual, who is also the registered provider and the manager who was in day-to-day charge of the service. The nominated individual is responsible for supervising the management of the service. We reviewed 4 people’s care records and 5 staff recruitment records, including evidence of training, supervision and ‘spot visits.’ We reviewed 3 people’s medicine records. We also looked at the service’s quality assurance arrangements and staff duty rosters.

Updated 27 February 2024

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.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service

Care at Hand Limited is a domiciliary care service providing the regulated activity of personal care to people in their own homes. At the time of our inspection there were 21 people 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

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. Staff communicated with people in ways that met their needs. Staff supported people with their medicines.

Right Care:

Concerns raised implied there may not always be enough staff to support people to stay safe. We have made a recommendation about staffing. People received kind and compassionate care. Staff treated people with dignity and respect and understood and responded to their individual needs. Staff had training on how to recognise and report abuse. People’s support plans reflected their needs and the risks posed.

Right Culture:

Where concerns and complaints were raised, these were not responded to in a timely manner. We have made a recommendation about complaints management. People received good quality care and support. Staff knew and understood people well and were responsive to their care and support needs.

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

Rating at last inspection

This service was registered with us in July 2023, and this is the first inspection.

The last rating for the service under the previous provider was Required Improvement, published in June 2021.

Why we inspected

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

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

Enforcement and Recommendations

We have identified a breach in relation to the provider’s quality assurance and governance arrangements. We have made recommendations about staffing and complaints management.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.