Hales Group Limited - Huddersfield

Updated 17 April 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

This inspection was conducted by 2 inspectors, a Regulatory Coordinator 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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 31/01/24 and ended on 21/02/24. We visited the location’s office on 31/01/24.

What we did before the inspection

Before the inspection, we reviewed all the information we held about the service including information about important events which the service is required to tell us about by law. We requested feedback from other stakeholders. These included the local authorities safeguarding teams, commissioning teams and Healthwatch from Kirklees and Bradford. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We spoke with 10 people who used the service and 4 relatives of people using the service. We spoke with care workers, senior care workers, care coordinators, the manager for the Bradford area, regional manager and the registered manager.

We looked at care records for 7 people using the service including medicine administration records. We looked at training, recruitment, and supervision records for staff. We also reviewed various policies and procedures and the quality assurance and monitoring systems of the service.

Updated 17 April 2024

About the service

Hales Group Huddersfield is a domiciliary care agency providing personal care to adults living in their own home. During our inspection visit, the service was caring for 115 people. 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. Care was provided across 2 local authority areas, Kirklees and Bradford.

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

We were not assured the service provided was always safe and we found shortfalls in the way the service was managed.

People did not always receive their care visits at the scheduled times; people and relatives told us about the negative impact this had on them. This issue was known by the provider, however the processes and procedures in place had not always been effective in ensuring improvements had been implemented in a timely way and instances of late visits had not always been investigated in line with the provider’s policies. We found examples where the safeguarding policies and procedures had not always been followed. The registered provider did not always inform CQC when safeguarding concerns were being investigated. We found several issues with the recording of medicines. The management of risks and care planning was inconsistent. Some people had comprehensive risk assessments and care plans, while other people had very succinct or even non-existent risk assessments. Overall, recruitment was managed well.

The provider failed to implement effective processes to monitor and improve the quality of the service and to act in a timely way on the issues they had identified, or on the issues found during our inspection. Records were not complete or contemporaneous. Management did not always follow the regulations, best practice guidance or their own policies and procedures.

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. However, we found the provider was not consistently recording relevant discussions and decisions about the care of people who lacked capacity to make decisions.

Although accidents, incidents and complaints were being analysed and lessons shared with the staff team, we found these were still reoccurring such as late visits or care being provided by male staff when people had requested female staff only. People and relatives shared mixed feedback about how confident they were that they would be listened to if they raised a complaint. Some people and relatives told us they had raised concerns to staff and no action had been taken.

People received support to maintain good nutrition and hydration and their healthcare needs were understood and met. The provider kept in close contact with relevant healthcare professionals.

Staff had received mandatory training, had relevant competencies assessed and were offered regular supervision.

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 on 29 April 2023 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about care visits not being completed on time, medicines, management of the service and compliance with registration requirements. A decision was made for us to inspect and examine those risks.

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 breaches in relation to person centred care, safe care and treatment, safeguarding, staffing and good governance at this inspection.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.