Harmony Care & Support Ltd

Updated 31 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. 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

The inspection was carried out by one inspector and one assistant inspector.

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 4 September 2019 and ended on 9 September 2019. We visited the office location on 6 September 2019.

What we did before the inspection

We reviewed information we had received about the service since registration and we sought feedback from professionals who work with the service. We used the information the provider 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 used all of this information to plan our inspection.

During the inspection

We spoke with 17 people who used the service and seven relatives about their experience of the care provided. We spoke with eight members of staff including the registered manager, operations manager, and support workers.

We reviewed a range of records. This included five people’s care records and medication records. We looked at elements of another two peoples care 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.

Updated 31 October 2019

About the service

Harmony Care and Support is a domiciliary agency that provides personal care and support to people living in their own homes. It provides support services to people with a range of needs such as physical disability, learning disabilities and autism. 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. At the time of the inspection 156 people were being supported by the service with personal care tasks.

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

We received mixed feedback about people's call times. People told us they felt they should be told about late calls and that didn't always happen. The registered manager had measures in place to monitor call times, and we saw action was being taken to improve this. There were also protocols in place to ensure people's safety.

People were sent rotas in advance to inform them of who to expect. However, some people told us they didn't always know which staff were due to complete their call as rotas were sometimes incorrect. This was mainly when changes had been made due to staff sickness or holidays. The registered manager was working to address this.

People felt the care they received was "outstanding" and carers were "brilliant." People told us their care was person centred, however some calls were not at the right time. People were understanding of this, when they knew the call was going to be at a different time. Staff were aware of people's life history, and their communication needs. They used this information to develop positive and meaningful relationships with people.

Care plans contained detailed information with regard to people’s support needs and were reviewed regularly. People, and where appropriate their relatives, were involved in the care planning process.

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.

Risks which compromised people’s health and well-being were appropriately assessed, reviewed when needed and contained detailed information. People told us they felt safe with the service.

Staff were caring and always promoted people’s dignity and independence. Staff were trained to support people safely and effectively.

There was a clear complaints policy for the service. Complaints we saw had been responded to appropriately. People told us they felt comfortable discussing any concerns with the service but did not always feel like they were listened to or informed of the outcome of feedback. We saw evidence of managers discussing some concerns with people and their relatives, and action plans were developed identifying improvements to be made. However, improvements weren't always clearly recorded, and it wasn't always evident how the registered manager had improved care as a result of identified issues.

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 1 March 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 re-inspection programme. If we receive any concerning information we may inspect sooner.