Harino Care Limited Head Office

Updated 23 October 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

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

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. They are referred to as the "registered manager" throughout the report.

Notice of inspection

We gave the service 48 hours' notice of the inspection visit as we needed to be sure that the registered manager and supporting office staff would be available.

What we did before the inspection

We reviewed the information the registered manager 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. This information helps support our inspections. We reviewed the notifications received from the provider, since the last inspection. The law requires providers to send us notifications about certain events that happen during the running of a service. We contacted local authority teams engaged with the service, including clinical commissioning groups, continuing health care groups, safeguarding and quality assurance teams.

During the inspection

The inspection site visit was completed on 5 and 9 September 2019. On 9 September 2019 we spoke with three people who used the service during home visits.

During the site visit we also spoke with the registered manager, nominated individual, the provider, the human resources manager, the care coordinator, two field supervisors, a senior care trainer and a support worker. The nominated individual is responsible for supervising the management of the service on behalf of the provider. After the site visit we spoke with four senior care trainers and 14 support workers. On 13 September 2019 we completed a telephone survey and spoke with 16 other people who used the service.

We reviewed the service care records, including eight people’s care plans and medicine administration records, risk assessments relating to skin care, falls management, and nutrition. We reviewed the daily progress notes of four people. We looked at ten staff recruitment and training files, together with the provider’s training and supervision schedules. We also examined other documents relating to the management of the service, including policies, procedures, quality assurance documents, audits and satisfaction surveys.

After the inspection

We spoke with eight community health and social care professionals. We continued to seek clarification from the provider to validate evidence found during the site visit and considered further documentation that had been provided following discussions with the registered manager.

Updated 23 October 2019

About the service

Harino Care Limited is a domiciliary care agency. It provides personal care to people living in their own homes. The service supported older people, people living with dementia and people with a physical disability. At the time of the inspection it was providing care to 135 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.

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

People were protected from avoidable harm by staff who had received appropriate training and knew how to recognise and report abuse.

Staff understood and provided the support people required to keep them safe and protect them from identified risks, such as malnutrition, falling, choking, developing pressure sores and infections.

There were enough suitable staff to meet people's needs and provide safe care. The registered manager and care coordinator had improved the coordination of visits to meet people’s preferred times to receive their care.

People received their prescribed medicines safely from staff who had completed the required training and been assessed to be competent. Staff had the necessary skills to meet people's needs and were well supported by the registered manager to develop their knowledge in line with good practice.

People had the necessary support to eat and drink to maintain a healthy balanced diet, in line with their needs and preferences.

Staff worked well with people, families and health and social care agencies to support people's wellbeing. People's health was effectively monitored by staff to ensure people received the right support from the wider health and social care network.

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.

Staff treated people with kindness and respect. People were supported to express their views about their care and their wishes were respected. People's privacy and dignity were respected and promoted during the delivery of their care.

People received personalised care that was responsive to their individual needs and preferences. Staff enabled people to raise concerns and complaints, which were responded to effectively to improve people's experience of the care provided. The service was not supporting anyone with end of life care. However, the registered manager had provided people with the opportunity to discuss their wishes and preferences in this regard, which were subject to regular review.

There was an open and positive culture within the service, which enabled and encouraged good communication with people, their families and other stakeholders. The registered manager effectively engaged with people, staff and professionals to seek their views, which were used to drive service improvements. Quality assurance processes were in place to ensure the provider had oversight of the service performance. The registered manager and staff co-operated well with key organisations to ensure the safe and effective delivery of people’s care.

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

Rating at last inspection

The last rating for this service was good (report published 18 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.