Archived: Network Healthcare - Harrow

Network Healthcare - Harrow is a is a domiciliary care service. It provides support and personal care to people living in their own homes, some of whom live with dementia. At the time of our inspection there were 75 people receiving personal care

Not everyone who used the service received personal care. The Care Quality Commission (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

At our last inspection we found that that people were at risk of not receiving their planned care and support due to late or missed calls. There was no formal process for checking people’s care calls had taken place and on time. Systems to learn and drive improvement in relation to staff punctuality had also not been in place. At this inspection we found the provider had followed their action plan and made improvements. Systems were in place to monitor care staffs’ timekeeping and to check that calls had not been missed. Quality assurance processes were in place to monitor the quality and safety of the service.

People told us they received their visits at the agreed times. Relatives told us the service was flexible and they were kept informed of any changes. No one reported having had a missed visit.

People told us they felt safe when receiving care and were happy with the support they received. Relatives spoke told us they felt their family members were safe when receiving care as regular competent care staff provided people with the care and support, they wanted and needed.

People’s risk assessments were detailed and included guidance for staff to follow to manage and reduce risks to keep people safe.

People had personalised detailed care plans. Care plans contained information to direct or guide staff on how to support people according to their needs and preferences. People had been involved in their development and review and were provided with paper copies which were held in their homes.

People and relatives told us that staff were always kind and respected people’s privacy and dignity

Staff were well-informed about people’s care needs. They undertook training that supported them to have the knowledge and skills to do their job well and to meet people's needs safely. Staff received the support and guidance they needed from the registered manager and other senior staff.

Staff were recruited safely. The had a plan for managing staffing levels and other areas of the service if the COVID-19 pandemic led to shortfalls and emergencies.

Staff were clear of their roles and responsibilities in relation to safeguarding. They knew how to recognise and report any concerns they had about people's welfare.

People and their relatives had opportunities to provide feedback about the service. Concerns raised via the survey were followed up with a call from the registered manager to the person to address the issue and to agree a resolution.

Systems were in place to ensure the effective and safe management of medicines. Medicine administration records were regularly audited to check that people had received their prescribed medicines.

Staff were provided with the personal protective equipment (PPE) that they needed. People told us that staff washed their hands and wore PPE during visits.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 3 September 2019) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Network Healthcare - Harrow 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.

Harrow is a domiciliary care service. It provides support and personal care to people living in their own home. At the time of our inspection there were 90 people receiving personal care.

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

People were not always receiving their care and support at the time it had been planned for because of late or missed calls. Therefore, people were at risk of not receiving care and support as required. Furthermore, there was no formal process for checking that care calls had taken place. The service did not have systems in place to continuously learn and drive improvement in relation to staff punctuality. This was because all the incidents of lateness had not been recorded or investigated to ensure appropriate action was taken and lessons learnt to prevent repeat occurrences.

Despite concerns regarding lateness, people still felt safe in the care they received from staff. Staff understood different types of abuse, which meant they could spot the signs of abuse and report concerns to relevant authorities. There were also systems and processes in place to minimise risks to people. Each person's care plan had several risk assessments and measures to reduce risk. People told us they received their medicines on time and as prescribed. However, we judged that people remained at risk as staff continued to be late for visits.

Before people started using the service, they were assessed to ensure the service could meet their needs. People were supported to have access the healthcare services they needed. There were arrangements to ensure that people’s nutritional needs were met. People’s dietary requirements, likes and dislikes were assessed and known about by staff.

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. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed.

People's needs had been assessed and care plans developed to ensure appropriate guidance was in place for staff to meet their needs. However, the guidance could have been more detailed. Each person’s preferred method of communication was highlighted in their care plans, which showed people’s communication needs had been considered.

The provider worked in partnership with key organisations such as the contract and commissioning teams and healthcare professionals to plan and deliver an effective service.

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

Rating at last inspection:

At our last inspection, the service was rated "Good". Our last report was published on 1 April 2016.

Why we inspected:

This was a planned inspection based on our scheduling of regulated services.

Enforcement:

At this inspection we rated the service as requires improvement. We identified two breaches of regulations, in relation to staff deployment and good governance. Please see the action we have told the provider to take at the end of this report.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.