Background to this inspection
Updated
19 January 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 22 November 2017. We gave 48 hours’ notice of the inspection visit, this was to ensure the manager was present. The inspection site visit activity started on the 17 November and ended on the 23 November. It included phone calls to staff and people who use the service and families. We visited the office location on 22 November 2017 to see the manager and office staff; and to review care records and policies and procedures.
The inspection team consisted of two inspectors 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. In this case the expert by experience had experience of service for people with disabilities and older care and people who lived with dementia.
Before the inspection, we reviewed the information we held about the provider such as notifications and any information people had shared with us. We also spoke with the local authority commissioning and safeguarding teams to ask them for their views on the service and whether they had any concerns. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. There were no concerns highlighted from the information provided.
During our visit to the provider's office we looked at three care records of people who used the service, three staff recruitment files, training records, medicines records and other records relating to the day to day running of the service.
During the inspection we spoke with the business manager who was responsible for the day to day running of the service and spoke to one care and support worker. We carried out telephone interviews with six care staff on the 17 and 23 November 2017. The expert by experience carried out telephone interviews with nine people who either used the service or their relatives on 21 November 2017.
Updated
19 January 2018
Our inspection of Safehands Services Ltd commenced on 17 - 22 November 2017 with phone calls to staff. We visited the office from which the service was managed. We spoke with three relatives and six people who used the service on 21 November 2017. The inspection was announced and the service was given 48 hours' notice to ensure someone would be in the office.
We last inspected this service in September 2016 and found a breach of Regulation 12 and Regulation 17. During this inspection we found improvements had been made to completion of medication administration records and the auditing of the quality and safety of the service.
Safehands Service Ltd is a domiciliary care agency. The service is situated close to the centre of Bradford. At the time of our inspection the service was providing care and support to 38 people. Safehands provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. Not everyone using Safehands receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
The service did not have a registered manager in place. The previous registered manager left June 2017. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The business manager, who was present during the inspection, had day to day responsibility for the running of the service. They were in the process of completing an application to become the registered manager.
Most people we spoke with told us they felt safe and did not raise concerns about the way they were treated. One person raised concerns about different staff visiting. Staff were aware of the actions they would take to keep people safe if they were concerned someone was at risk of abuse. Appropriate systems were in place to protect people from the risk of harm.
Overall risks to people’s health, safety and welfare were identified and action taken to manage the risk. Staff demonstrated a sound awareness of infection control procedures.
Medicines were managed safely. However, some improvements were needed to ensure a consistent approach. We recommended the provider reviews their medicines policies and procedures in line current guidance.
Recruitment processes were in place although we found on one occasion these had not been followed. Checks to show staff were safe to work with vulnerable adults were undertaken prior to staff working at the service.
People were provided with care and support by staff who were trained. Staff told us they had received induction and training relevant to their roles. This was followed up by competency checks. Staff received regular supervision. One staff member thought more group meetings would be beneficial.
People told us they were supported to had choice and control of their lives and staff supported them in the least restrictive way possible.
People told us staff usually turned up within the allotted time, or they phoned and let them know they were running late.
Staff were spoken of highly by most people who told us they were caring, kind, compassionate and respected their dignity and privacy.
Care records contained sufficient detail so staff knew what support to offer people. People felt they participated in planning their care. Care records included information about preferences, likes and dislikes.
People were supported with their nutritional needs. People had access to a wide range of healthcare professionals and we saw evidence people’s healthcare needs were met.
A complaints procedure was in place which enabled people to raise any concerns or complaints about the care or support they received. However, one person told us they felt concerns they had raised were not dealt with.
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People using the service, relatives, staff and healthcare professionals we spoke with were generally positive about the management team. Staff said the manager was approachable and supportive.
The service had quality assurance processes which considered certain aspects of care delivery. However, the more general service delivery was not audited as can be seen by the issue we found with recruitment records.