Havesters Care Ltd

Updated 15 October 2022

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 conducted by one inspector and two Experts 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.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post who was also the provider.

Notice of inspection

We gave a short period notice of the inspection 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 30 August 2022 and ended on 12 September 2022. We visited the location’s office on 30 August 2022.

What we did before the inspection

Before the inspection we reviewed information, we had received about the service, including previous inspection reports, information sent to us by the public and notifications. Notifications are information about specific important events the service is legally required to send to us. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We spoke with fourteen people who used the service and seven relatives of people about their experience of the care provided. We spoke with the registered manager, care coordinators, office staff and care staff. We reviewed a range of records. This included thirteen people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed. We received feedback from two external professionals.

Updated 15 October 2022

About the service

Havesters Care Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. The service was supporting 92 people at the time of the inspection. 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

People's care plans were up to date and contained person centred information. However, not all people’s risk assessments contained information which would enable staff to understand how to keep them safe and mitigate the risk of harm. This placed people at risk of not receiving the appropriate care and treatment they required. We have made a recommendation about this in the report.

There were quality assurance systems in place based on a range of audits. However, we found these needed to include more detail to enable them to be effective. They had not identified all the concerns identified in this inspection. People and their relatives gave us mixed feedback. While some told us, they were happy with the care provided and staff were caring and compassionate, others felt they did not always get a good service.

Staff did not feel supported in their role and felt they were not listened to if they raised concerns. This impacted on the culture of the service. We have made a recommendation about this in the report.

The management team had processes for monitoring visits. Although some people, were satisfied they received visits on time, others said they were not always told when staff were running late. Staff told us they did not feel they had enough time to travel to visits.

Staff understood the importance of safeguarding people they supported, and they knew how to report any signs of abuse, or any accidents and incidents.

Staff had completed training in the safe administration of medicines and had their competency assessed to do so safely. People were happy with how they were supported around their medicines.

Staff received an induction into their role and had received training that equipped them to support people. Safe recruitment procedures were in place to help ensure only suitable staff were employed.

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. However, further improvements were needed to ensure records were made for all decisions made using The Mental Capacity Act 2005.

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 7 June 2021). 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 some improvements had been made but the provider remained in breach of regulation.

At our last inspection we recommended that the provider consider current guidance on the management of medicines, review current guidance on ensuring staff have skills, knowledge and experience, consider current guidance on supporting people with their nutrition and hydration and consider guidance on the implementation of the Accessible Information Standard. At this inspection we found the provider had acted on these recommendations and made improvements in these areas.

Why we inspected

We carried out an announced comprehensive inspection of this service on 27 April 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve consent to care, notifying the commission of significant events, fit and proper persons employed and governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. In addition, we received concerns in relation to staff training and lack of skills leading to neglect of people receiving a service. As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive 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 remained requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Havesters Care on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a continued breach in relation to governance systems at this inspection. In addition, we have identified areas for improvement and have made recommendations in relation to risk assessments, acting on staff feedback and improving the culture of the service.

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.