Background to this inspection
Updated
2 March 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 one inspector and an Expert by Experience who made phone calls to people and families for feedback about the service. 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.
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 a registered manager in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 4 January 2023 and ended on 19 January 2023. We visited the location’s office on 5 January 2023.
What we did before the inspection
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 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 used all this information to plan our inspection.
What we did during the inspection
We spoke with the registered manager, two senior staff and three care staff. We reviewed a range of records. This included three people’s care records and 3 staff files. We looked at a sample of the service’s quality assurance systems including medication and care plan audits.
Following the visit to the service, we continued to seek further clarification from the registered manager. We had contact with 6 people using the service, 9 relatives and 2 professionals for feedback about the service.
Updated
2 March 2023
About the service
Heritage Staffing Services is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 71 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
We received negative feedback from some people and their representatives, especially when people were being supported by staff they did not know. In these instances, we were told care was rushed and task-focused. Feedback was positive about care provided by named staff.
Systems were not always being used to manage risk and promote wellbeing, such as the monitoring of visit times. The registered manager was committed to improving the service and learning lessons after feedback. However, they did not always check to see whether any changes they had made were working. The provider had not always notified CQC, as required.
Staff did not always work alongside other professionals to manage risk and ensure there were no gaps in care. Improvements were needed to the care planning and monitoring of the medicines people received. Some staff did not minimise the risk of infection when cleaning people’s homes. Staff minimised the risk of COVID-19 through their use of personal protective equipment.
Staff had the skills to meet people’s needs. Staff were recruited safely. Staff were positive about the registered manager and communication within the service.
The registered manager had taken action to safeguard people when concerns were raised about an individual’s safety. 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.
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 10 September 2018).
Why we inspected
We received concerns following safeguarding investigations around quality of care and management of the service. 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 report.
The registered manager provided assurances they were taking action in relation to the concerns we found.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Heritage Staffing Services on our website at www.cqc.org.uk.
Enforcement
We have identified a breach in relation to poor governance at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.