Home Angels Healthcare Services Ltd

Updated 1 September 2023

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 carried out by 2 inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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 not a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We spoke to the local authority to gain feedback regarding the service. We reviewed information we held about the service since the last inspection. We also looked at online reviews regarding the service. We used all this information to plan our inspection.

During the inspection

We spoke to 4 staff including the care manager, compliance officer, director and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records including 4 people’s care plans and risk assessments and incident and accident records. We also reviewed the service’s governance systems, including audits and feedback from people and relatives.

Updated 1 September 2023

About the service

Home Angels Healthcare Service Ltd is a domiciliary care agency providing personal care to people. The service provides support to children, younger adults, older people and people who may have dementia, a physical disability or sensory impairment. At the time of our inspection there were 14 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

People’s risk assessments were not always up to date or included enough information in order to keep people safe and mitigate those risks. The visits were scheduled using an online system and this was overseen by the registered manager. People were not always happy with the way staff provided care and support. We have made a recommendation regarding the providers recruitment records of new staff.

Staff had received training in topics the registered manager considered mandatory. However, the training was not in line with best practice guidance. The registered person had not followed up on the recommendation made at the last inspection relating to referring to best practice guidance regarding staff training. 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.

The provider did not ensure systems were in place to oversee the service and ensure compliance with the fundamental standards. They did not ensure the Care Quality Commission (CQC) was informed of notifiable incidents in a timely manner.

The staff team followed procedures and practices to control the spread of infection using personal protective equipment.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 10 January 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last 4 consecutive inspections. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

At our last inspection we recommended that the provider ensures staff training is up to date and seek advice and guidance to ensure training is in line with best practice. At this inspection we found the provider had not made enough improvement.

Why we inspected

We carried out an announced focused inspection of this service on 1 December 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve recruitment records and good governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Home Angels Healthcare Services Ltd on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to risk assessments, staff training and notifications of incidents to CQC.

We have made a recommendation regarding recruitment records.

We issued a Warning Notice to the provider regarding relating to good governance. The provider is working with us to address the issues raised.

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.