Home Sweet Home Care Limited

Home Sweet Home Care Limited is a domiciliary care agency providing the regulated activity of personal care. The service provides support to adults, many of whom are older people and some who require support with palliative care. At the time of our inspection there were 176 people using the service who received support with personal care.

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

Staff were often late for appointments with people. Medicines were not always managed in a safe way.

Systems were in place to help safeguard people from abuse. Risk assessments were in place which set out the risks people faced and included information about how to mitigate those risks. Steps had been taken to help prevent the spread of infections. Systems were in place for investigating accidents and incidents.

There was an open and positive culture at the service, which meant people, relatives and staff could express their views. The provider worked with other agencies to develop best practice and share knowledge. The provider was aware of their legal responsibilities.

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 Good (published 17 November 2017).

Why we inspected

We received concerns in relation to staff punctuality and staff not staying for the full amount of time they were supposed to. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 changed from Good to Requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

The provider has taken steps to mitigate risks we identified, but at the time of writing this report, it is too early to tell if they will be effective or not.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement

We have identified breaches in relation to staff punctuality and the safe management of medicines at this inspection. 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 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.

The service is registered with CQC to provide support with personal care to people living in their own homes. At the time of our inspection 19 people were using the service. The service had a registered manager in place. 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.

There were enough staff working at the service to meet people’s needs and robust staff recruitment procedures were in place. Appropriate safeguarding procedures were in place. Risk assessments provided information about how to support people in a safe manner. Medicines were managed in a safe way.

Staff received on-going training to support them in their role. People were able to make choices for themselves and the service operated within the principles of the Mental Capacity Act 2005. People told us they were able to make choices about what they ate. People were supported to access relevant health care professionals.

People told us they were treated with respect and that staff were caring. Staff had a good understanding of how to promote people’s privacy, independence and dignity.

Care plans were in place which set out how to meet people’s individual needs. Care plans were subject to regular review. The service had a complaints procedure in place and people knew how to make a complaint.

Staff and people spoke positively about the senior staff at the service. Quality assurance and monitoring systems were in place which included seeking the views of people who used the service.

We have made two recommendations in this report because records were not always maintained of staff supervisions and team meetings and some people had concerns about staff punctuality.

There was a registered manager in post. 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.

Home Sweet Home Care Limited provides support with personal care to adults living in their own homes. At the time of our visit they were providing personal care to 38 people and had 24 staff working for them. The service has recently moved location and is presently going through the process of registering their new address with us.

People told us they felt safe using the service. However the provider needed to improve on their staff recruitment process to ensure new staff were suitable before they began working.

Staff were trained in how to protect people from abuse and harm. They were knowledgeable regarding safeguarding and knew how to raise concerns when necessary. We found the registered manager had informed the local safeguarding team of incidents that affected people’s safety and wellbeing however we were not notified as required by law.

Risk assessments were individualised and centred on the needs of people and there was guidance for staff to follow to reduce identified risks. Risk assessments had also been completed to ensure the environment staff were working in was safe.

Staff were trained in a number of areas and knew the needs of the people they were supporting well. They had regular meetings either formally or informally with their line manager to ensure they were supporting people based on their needs. We have made a recommendation about keeping a written record of staff supervision.

People’s medicines were managed safely and staff were trained to administer them as they were prescribed.

Care plans were detailed, specific to the person and reflected people’s choices and preferences. They were reviewed and updated when people needs changed to make sure people received the care and support they needed. This was done with the participation of people or their representatives. Staff understood how to meet people needs.

Staff sought and obtained people’s consent before they provided them with support. They were knowledgeable in the principles of the Mental Capacity Act 2005 (MCA) and the requirements of the legislation.

People were supported to maintain good health and were referred to health care professionals when needed.

People’s nutritional needs were met. Staff prepared their meals based on their individual preferences and choices.

People said the staff were kind and caring in their approach and their privacy and dignity was maintained. They were happy with the way staff supported them. Staff encouraged people to do as much as possible for themselves to promote their independence.

People were confident they could raise any concerns or complaints with the registered manager and these would be addressed.

There were quality assurance systems in place to monitor the quality of the service. The registered manager sought people’s views and acted upon them.