31 January 2024
During a routine inspection
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.