H+B Homecare Services improved from requires improvement to Good overall, with previous breaches around safe care, consent and governance now resolved. Well-led remains requires improvement as monitoring systems did not consistently highlight shortfalls such as missing PRN medicine protocols.
Concerns (4)
moderateGovernance: “the provider's monitoring systems were not always consistently highlighting shortfalls. For example, not all as required medicines had a protocol in place.”
moderateLeadership: “The rating for this key question has remained requires improvement. This meant the service management and leadership was inconsistent.”
minorMedication management: “one person had barrier cream applied as required (PRN). Guidance for use of the barrier cream was included in the care plan but not recorded on the medicine administration records (MARs).”
minorMedication management: “as required paracetamol which was recorded on the MARs appropriately but did not have a specific PRN protocol explaining when it should be administered.”
Strengths
· Risk assessments in place and regularly reviewed, including COVID-19, choking, diabetes and mobility
· Safe recruitment practices including DBS checks, references and identity checks
· Staff received relevant training, induction, supervision and competency assessments
· People reported staff arrived on time and provided consistency of care
· Consent to care obtained appropriately in line with MCA principles
Quality-Statement breakdown (17)
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
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
well-led: Continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement
well-led: How the provider understands and acts on the duty of candourRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Engaging and involving people using the service, the public and staffRequires improvement
well-led: Working in partnership with othersRequires improvement