Background to this inspection
Updated
22 February 2020
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 Care Act 2014.
Inspection team
One inspector, one assistant inspector, and one Expert by Experience carried out this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 20 January 2020 and ended on 24 January 2020. We visited the office location on 23 January 2020.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.
We spoke to two people who used the service about their experience of the care provided and seven relatives.
We used all of this information to plan our inspection.
During the inspection
We spoke with two care workers, the registered manager and the nominated individual who were both Directors of the service. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We spoke to four people using the service, and one relative.
We reviewed a range of records. This included six care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
We spoke to a further two care workers. We also received feedback from three social care professionals and one health professional.
Updated
22 February 2020
About the service
Heritage Care at Home Ltd is a domiciliary care agency. It provides personal care to people living in their own homes in rural and coastal areas of Suffolk. At the time of our inspection they were supporting 51 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 supported by staff who had completed the relevant training to give them the skills and knowledge they needed to meet their needs. People were supported to have sufficient amounts to eat and drink and were protected against the risk of poor nutrition. Staff supported people to maintain their health and well-being. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. However, care records needed to be strengthened in some areas to ensure the principles of the Mental Capacity Act 2005 were being followed. We have made a recommendation about this.
Risks had been assessed and those identified were safely managed; some improvements were however needed to ensure adequate guidance was in place for staff delivering care. The provider had recruitment checks in place to ensure staff were suitable to work in people's homes. Staff showed a good understanding of their roles and responsibilities of keeping people safe from harm. Medicines were managed safely.
Staff treated people in a kind and caring way. People and relatives valued the service and the support the staff provided. Staff treated people with respect and helped them to maintain their independence and dignity.
People were supported to express their wishes and preferences regarding their care and staff provided personalised care. Care records needed further detail in some cases to ensure they were person-centred and sufficiently detailed for staff. People and relatives were confident to raise concerns and complaints, and these were listened to, resolved and used to drive improvements in the service.
The provider had systems in place to monitor the quality of the service to ensure people received good care. People, relatives and staff were given the opportunity to feedback on their experience of the service.
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 (published 17 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heritage Care at Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.