Holistic Community Care Limited achieved a Good rating across all five key questions at this November 2023 inspection, representing an improvement in Safe from the previous Requires Improvement rating largely due to remediated medicines management. Minor issues with occasional visit delays and complaints resolution timeliness were noted but did not detract from an otherwise well-managed, person-centred service.
Concerns (3)
minor
Missed or late visits
: “some people had experienced delays in their call visits... 'They are sometimes a bit late, but they use the buses so can make them late'”
minorMedication management: “we identified two care plans that did not reflect complete information about people's medicines on the Electronic Monitoring System (EMS), for example side effects of medications.”
minorComplaints handling: “A number of people told us they had experienced delays in getting their complaints resolved.”
Strengths
· People felt safe and staff demonstrated strong understanding of safeguarding responsibilities, including whistleblowing procedures.
· Medicines management had significantly improved since the previous inspection, with competency testing and audits in place.
· Staff received regular training, supervision, and specialist training for complex conditions such as stoma care and catheter management.
· People received care from consistent, regular staff teams, enabling positive and meaningful caring relationships.
· Care plans were detailed, person-centred, and regularly reviewed to reflect changing needs.
Quality-Statement breakdown (25)
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuse and avoidable harmGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood
Holistic Community Care Limited was rated Good overall at its September 2017 inspection, with 251 people receiving personal care across five London boroughs. The single area of Requires Improvement related to medicines administration records, which lacked detail on type, dosage, route and timing, though the provider implemented a MAR chart system during and immediately after the inspection.
Concerns (3)
criticalMedication management: “care staff did not complete a Medicine Administration Record (MAR) and it was therefore unclear what medicines people had received.”
moderateStaff training: “not all staff had received up-to-date training. For example, there were instances where safeguarding and medicines training had expired.”
minorSupervision / appraisal: “Although we found examples of staff who were due supervisions, staff told us they felt confident in seeking support and guidance at any time.”
Strengths
· People were protected from harm and abuse; staff had strong safeguarding knowledge and clear escalation pathways.
· Robust recruitment procedures including DBS checks, two references, and employment history verification.
· Staff supported people to communicate in their preferred language, including recruiting Portuguese-speaking staff.
· Care plans were reviewed regularly and changes shared with staff to ensure responsive, person-centred care.
· Complaints were fully investigated with outcomes documented and shared with healthcare professionals.
Holistic Community Care Limited's Unit 4B received a Good rating across all five key questions at its February 2015 inspection, demonstrating safe and person-centred homecare to 365 people across five London boroughs. Minor issues noted included occasional late visits and an unanalysed satisfaction survey, but no regulatory breaches were identified.
Concerns (3)
minorMissed or late visits: “some people said sometimes they arrived later than they had arranged”
minorPerson-centred care: “Some people said that care workers who came to them occasionally did not know their needs so well...One person said they found this tiring”
minorGovernance: “The most recent survey in late 2014 had not been analysed at the time of our inspection.”
Strengths
· All staff received safeguarding training at induction with refresher training, and staff were confident in reporting concerns
· Robust risk assessment processes covering moving and handling, medical conditions, pressure sores, falls and environmental risks
· Safe recruitment processes including criminal records checks, references and probationary period
· Sufficient staffing levels with electronic monitoring of timekeeping and area-based allocation to reduce travel time
· Regular supervision and spot checks approximately four times a year per care worker
effective: Nutrition and hydration
Good
caring: Kindness, compassion and dignityGood
caring: Equality, diversity and inclusionGood
caring: Independence and involvementGood
caring: Confidentiality and privacyGood
responsive: Care planning and personalisationGood
responsive: Activities and social inclusionGood
responsive: Complaints handlingGood
responsive: Timeliness of visitsGood
well-led: Leadership and management cultureGood
well-led: Governance and auditingGood
well-led: Partnership workingGood
well-led: People's feedback and quality assuranceGood