We carried out a review of the data available to us about Holistic Social Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Holistic Social Care, you can give feedback on this service.
Holistic Social Care is a small domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. On the day of our inspection there were four people receiving the regulated activity of personal care, which was approximately 80 hours per week.
At the last inspection in June 2017 we identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to one person’s risk assessment not capturing their assessed needs.
During this inspection on 5 and 6 September 2018 we found improvements had been made towards meeting the requirements to help ensure people received an improved quality of service and there was no longer a breach of regulation.
The service had a registered manager who had been registered with the Care Quality Commission (CQC) since December 2015. 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.
We found there were systems in place to protect people from the risk of harm. Staff we spoke with were able to explain the procedures to follow should an allegation of abuse be made. Assessments identified risks to people, and management plans to reduce the risks were in place to ensure people's safety.
People praised the kind and caring approach of staff. Staff were respectful and explained clearly how people's privacy and dignity were maintained. Staff understood the needs of people and care plans were person-centred. People and their relatives spoke very positively about the care provided.
There were sufficient staff available to ensure people's wellbeing, safety and security was protected. An appropriate recruitment and selection process was in place which ensured new staff had the right skills and were suitable to work with people living in their own home.
Staff had a good understanding of systems in place to manage medicines and safeguarding matters, although at the time of our inspection people did not require support with their medicines.
The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA).
People we spoke with said they involved in care planning and were confident that their comments and concerns would be acted upon.
The registered manager promoted an open and inclusive culture within the service. Carer workers felt valued and well-supported in their work.
People had no complaints about the service they received or about the staff that provided their care and support; they were aware of the complaints procedure and processes and were confident they would be listened to should they raise any concerns.
There were systems in place to monitor and improve the quality of the service provided.
Holistic Social Care Manchester is a domiciliary care agency and provides care and support to people within their own homes. The administrative office is located in Whalley Range, Manchester. At the time of this inspection the agency supported three people. This was the first inspection since the service was registered with the Care Quality Commission (CQC) in December 2015.
The service had a manager who had been registered with CQC since December 2015. 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.
People told us they felt safe with the care and support they received from the agency. Staff we spoke with could tell us about the types of abuse and what action they would take if they suspected that abuse was taking place. Staff members had received mandatory safeguarding training. This meant people using the service were protected from risk as staff knew what to do if they identified concerns.
There were some risk assessments in place to help ensure staff knew how to support people safely. However not all aspects of a person’s care had been risk assessed. This meant staff did not have sufficient information to manage risk safely. Risk assessments did not contain the dates on which the assessment had been done. This made it difficult to determine if these documents were up to date.
The agency implemented safe recruitment processes to help ensure care staff were fit for the job they were recruited to do. This should help to ensure people were kept safe from harm.
Medication support was not provided to anyone using the service at the time of this inspection. Some staff had been trained to administer medications in a safe manner.
People using the service and their relatives told us staff had never missed a visit and that care staff were consistent. Care staff were always introduced to the people they would be caring for prior to providing the service. This meant people were cared for by staff that were familiar with their care needs.
Staff were knowledgeable of good infection control practices, which should help to ensure people were protected from risk of infection. Relatives confirmed that staff wore personal protective equipment as required and they showed us where these were kept in their homes.
The agency had systems in place for reporting and recording accidents and incidents that took place within the service. Two incidents had been reported though neither incident had involved people using the service.
People and their relatives said care staff had the right skills and knowledge needed to undertake their caring role effectively. Care staff received an induction and mandatory training in key areas such as safeguarding and moving and handling. This should help to ensure that care staff supported people safely and effectively.
Care staff told us and records confirmed they received regular supervisions with their manager. This meant care staff were supported carry out in their role in an effective way.
Care staff always sought people’s permission before they carried out their caring duties.
The registered manager and care staff were knowledgeable about the Mental Capacity Act and what that meant to them as care providers and the impact this legislation had on helping to ensure people’s rights were protected.
Some care records we looked at were signed by people’s relatives without the appropriate legal authorisation. While this demonstrated that family members were encouraged to be involved in the care planning process they do not automatically have legal authority to give permission for proposed care or support. The registered manager understood their role in relation to the mental capacity act and provided assurances they would implement the necessary changes to ensure consent to care was sought appropriately at all times.
Staff we spoke knew what to do if a person they were supporting required medical attention. People we spoke with were confident their care staff would help them according to their needs.
Care staff supported people with meal preparation thus helping to ensure people’s dietary needs were met.
People and their relatives told us care staff were kind and caring. They said they got on well with staff and had developed a good rapport with them. Some care staff were of the same cultural backgrounds as the people they supported, speaking the same language and having a good cultural knowledge. This meant people felt cared for and supported by staff who understood their specific needs.
Care documentation contained detailed information about people’s current and past experiences and their care needs. This provided staff with clear and specific information and helped to ensure people were supported in a responsive way.
People and their relatives knew how to make a complaint. We saw the service had effective systems in place to investigate these and to learn from any concerns that had been raised.
The agency had been commissioned by a clinical commissioning group to provide care and they were positive about the interactions they had had with the registered manager and the care staff. They told us the agency provided care and support that was person-centred and responsive to the person’s needs.
People using the service and their relatives were complimentary about the service they received and would recommend the agency to others.
Care staff told us the registered manager was helpful and approachable and that the agency was a good organisation to work for.
There were some audit processes in place such as staff spot checks. We noted not all audit processes had been documented. We found errors in records which an effective audit system should have identified. This meant quality assurance processes needed to be more systematic to help ensure the quality of service was monitored effectively to prevent negative impact on people’s wellbeing.
There were policies and procedures in place to help guide and support staff in their role. Staff meetings were held regularly and gave care staff the opportunity to discuss their work and receive management support.
We have made a recommendation that the provider implement more systematic quality assurance arrangements.
We found one breach in the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014 in relation to safe care and treatment. You can see what action we told the provider to take at the back of the full version of the report.