6 January 2023
During a routine inspection
Harmony Projects is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and children with various needs including, physical disabilities and people living with dementia or a learning disability. At the time of this inspection 43 people were using the service.
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
Systems were not robust enough to demonstrate medicines were effectively managed. People's medicines records did not always contain enough detail. People’s allergies were not recorded. Although a medicines audit tool was in place and being completed regularly it did not pick up on the discrepancies we found during the inspection.
There was mixed feedback from staff about the provider and wider management team, some staff felt supported in their roles whilst others didn't. The provider had poor management systems in place to support oversees staff with their employment at the service. Staff told us about various issues with their employment and contracts. We escalated these concerns to the local authority.
Care plans did not consider people's end of life wishes. We fed this back to the provider, who told us they would take action to ensure people’s end of life wishes would be discussed and included in people's care plans.
Staff had received training in safeguarding people. People were protected from the risks of abuse and staff were trusted to keep them safe. People's care needs were risk assessed and people’s ongoing risk assessments were reviewed on a regular basis and when needs changed.
Recruitment checks were robust to ensure staff were suitable to work with vulnerable adults. Staff had received an induction when they first started working at the service and training relevant to their roles had been provided.
People told us staff were on time for their visits, however, when staff were delayed, people were not always informed. The provider was already aware of this feedback and had spoken to staff to resolve the issue.
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.
At the time of the inspection, the location did not provide personal care for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
Staff knew people's histories and preferences and used this knowledge to support them in the way they wanted. People’s views and decisions about care were incorporated when their care packages. People were involved in making decisions about their day to day care. People were treated with dignity, privacy and respect. People’s independency was encouraged where possible and this was reflected in people’s care plans.
People’s communication needs were met. The service was aware of the Accessible Information Standard (AIS) and each person’s specific communication needs were detailed in their care records. Complaints had been responded to in line with the providers complaints policies and procedures.
Person-centred care was promoted. The provider and staff demonstrated a commitment to people, and they displayed person-centred values.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
This service was registered with us on 13 November 2019 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We have identified a breach in relation to the effective management of medicines at this inspection. We have made a recommendation in relation to people’s end of life wishes
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.