Health and Care at Home

Updated 9 August 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

This inspection was carried out by one inspector and an Expert by Experience. 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. The registered manager 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 2 working days’ notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection.

Inspection activity started on 20 July 2023 and ended on 21 July 2023. We visited the office location on 21 July 2023.

What we did before the inspection

We reviewed information we held about the service and the provider which included any statutory notifications sent to the CQC. A notification is information about important events which the service is required to send us by law. The provider had completed 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 used all this information to plan our inspection.

During the inspection

We reviewed 2 people's care plans and risk assessments. We reviewed 3 recruitment files, staff training and supervision. We also reviewed other records relating to the management of the service. We met with 3 care staff during the office visit. We spoke with the registered manager and the care director. We spoke with 7 relatives and 2 people receiving care and support. Following the office visit we contacted all the remaining care staff via email. We received feedback from 2 staff.

Updated 9 August 2023

About the service

Health and Care at Home is a community-based care provider that provides personal care to people living in their own homes. At the time of inspection 23 people were receiving a service and were in receipt of the regulated activity of 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

There were sufficient staff employed to cover the visits required by people.

Staff were provided with adequate travel time to enable them to carry out visits at the time of the person’s choosing.

Risks were identified, assessed and recorded. Environmental risks to visiting staff were also assessed.

Care plans were completed for each person and contained details of the person’s needs and preferences. Care plans were reviewed regularly to help ensure they were up to date and relevant.

People told us they felt safe when being supported by staff and were able to increase their independence in a way that felt comfortable for them. There were systems to help protect people from abuse and to investigate any allegations, incidents or accidents.

Recruitment processes were robust, and new staff had sufficient support during their induction before working alone with people.

There were robust auditing or monitoring processes in place at the time of this inspection. People were regularly asked for their views and experiences of the service provided.

The service had implemented effective quality assurance systems to monitor the quality and safety of the service provided. Spot checks were carried out to monitor staff performance. Staff were well supported and asked for their views.

People and their relatives spoke positively about staff and told us they were happy with the service they received. We were told staff were friendly, they were treated with kindness and compassion and their privacy and dignity was respected. Comments included, “They (Health and Care at Home) are exceptionally good. We have had two other companies and we were always having trouble with the previous ones. That’s how I know how good they are,” “It’s very well run. They are continuously improving and updating policies and procedures, maximising staff quality. I think they are sensitive. (Manager’s name) is lovely, they know what they are talking about, they are organised and very experienced,” “They are fantastic, I can’t fault them at all” and “They all ring me occasionally if there are any issues. Always polite, helpful. I know I can ring them if I needed to. The managers are lovely.”

People were supported by staff who had been appropriately trained and were skilled in their role.

People received support to maintain good health and were supported to maintain a balanced diet where this was part of their care plan.

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 understood the importance of respecting people's diverse needs and promoting independence. People were always asked for their consent prior to care being provided.

There were clear lines of responsibility which were known and understood by the staff team. Audits of all aspects of the service were completed by the registered manager.

There was a registered manager at the time of this inspection.

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 inspection for this service was rated requires improvement. (published 29 March 2022)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.