Hallam24 Healthcare

Hallam24 Healthcare is a domiciliary care service which provides personal care to adults with a range of support needs in their own homes. At the time of this inspection the service was supporting 29 people.

People’s experience of using this service and what we found

Risks to people had not been fully assessed. There was not always guidance for staff on how to best manage risks. Accidents and incidents were not analysed, which meant staff could not learn from these events. The systems in place to ensure people received their medicines as prescribed were not effective.

Care records did not always contain an accurate assessment of all of people’s care and support needs. Care records were not always person-centred. Effective systems had not been established for identifying, receiving, recording, handling and responding to complaints.

The registered manager had not acted on most of the recommendations made at our last inspection. In addition, at this inspection we identified new concerns with regard to medicines management and complaints. The registered manager had not established effective quality assurance processes. They did have some audits in place, however these had not identified the issues we found during this inspection.

The provider had effective recruitment procedures in place to make sure staff had the required skills and were of suitable character and background. Staff understood what it meant to protect people from abuse. Most people told us staff were kind and caring. The provider had policies and procedures which reflected current legislation and good practice guidance.

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

Rating at last inspection

The last rating for this service was requires improvement (published 12 April 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two inspections.

Why we inspected

We received concerns in relation to the management of the service. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hallam24 Healthcare 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 will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to good governance, management of medicines and responding to complaints. 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 for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authorities to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service:

People were happy with the service they received and felt staff were dedicated, well trained, kind and respectful. Staff demonstrated a positive attitude to people’s safety, care and support.

Risks were identified but not always thoroughly, and medicines management was not robust.

We have made a recommendation about assessing and monitoring risk.

Staff were recruited safely and there were enough staff, although we received mixed views from staff about the timings of their visits to people.

Staff had training and supervision, although this was not always robust or clearly recorded and there was a limited overview of staff skills within the whole service. Some staff did not feel they had enough training, although others felt they were suitably trained.

We have made a recommendation about training, supervision and spot checks.

Staff understood how the service was run and gave positive feedback on the whole, although not all staff were clear who the registered manager was and related more to the director. Staff reported feeling well supported with good teamwork and morale overall. The service had recently increased the number of people they supported, although quality audits and recording to show how the service was being run had not been made sufficiently robust to reflect the growing demands of the service.

We have made a recommendation about quality assurance.

People were supported by staff who were kind and caring. Staff said the care would be good enough for their own relatives overall. Care records were not always robust enough to give staff up to date information and there were limited ways to share records with individuals who may have a sensory impairment.

We have made a recommendation about people’s care records.

The provider recorded and responded to complaints and compliments and valued people’s feedback about the service. The provider was keen to develop robust partnership working and consider how any learning from issues raised could be used to improve the service.

Rating at last inspection: Good (report published 26 August 2016). At this inspection, the rating has dropped to Requires Improvement.

Why we inspected: This was a planned inspection based on the rating at the previous inspection.

Follow up: The service will continue to be monitored in line with our inspection programme and if information of concern is raised this will be investigated.

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

Hallam 24 Healthcare is a domiciliary care service. They are registered to provide personal care to people in their own homes. At the time of our inspection the service was supporting people with a variety of care needs including older people and people living with dementia. Care and support was co-ordinated from the services office which is based in Barnsley.

There is a registered manager which oversees services provided from the office. 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.

At the time of our inspection there were five people using the service. We spoke on the telephone with two people who used the service and three relatives. We asked people about their experiences of using the agency. People we spoke with told us they were entirely happy with the service provided.

People told us they felt safe in their own homes and staff were available to offer support when needed, to help them maintain their independence. One person told us, “The staff are loving and kind. Nothing is too much trouble for them.”

People’s needs had been assessed before their care package commenced and they told us they had been involved in formulating and updating their care plans. We found the information contained in the care records we sampled was individualised and identified people’s needs and preferences, as well as any risks associated with their care and the environment they lived in.

We found people received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and their care package amended to meet their changing circumstances. Where people needed support taking their medication this was undertaken in a timely way by staff that had been trained to carry out this role.

The recruitment of staff was safe which ensured staff were employed with all of the required employment checks. There was sufficient trained staff employed to ensure people received their care consistently. People told us that they received support from the same care workers.

People were able to raise any concerns they may have had. We saw the service user guide included ‘how to make a complaint.’ This was written in a suitable format for people who used the service. Relative we spoke with told us they were confident that any concerns that they needed to make would be dealt with swiftly.

People were encouraged to give their views about the quality of the care provided to help drive up standards. The quality assurance systems were effective in identifying areas for improvement. This gave the service an opportunity to learn from events and improve the service for people.