HICA Homecare - Grimsby was rated Good overall, with Good ratings for both Safe and Well-led at this focused inspection covering those two key questions only. Minor concerns were noted around variability in visit arrival times and inconsistent sign-off of quality audit actions, but no regulatory breaches were identified.
Concerns (3)
moderateMissed or late visits: “"Normally there is a lot of variation in visit arrival times" and "They come to visits at anytime, I've had to cancel hospital appointments as the carers were late."”
minorGovernance: “Where improvements to the service had been identified through quality auditing, action was not always revisited and signed off.”
minor
Communication with families
: “Some people said the office staff do not answer the phones, speak in an unprofessional manner, and do not act on concerns shared.”
Strengths
· Medicines were managed safely with electronic records, regular staff competency checks and medicine audits.
· Staff were safely recruited with pre-employment checks including DBS, references and right-to-work verification.
· Staff received induction and up-to-date training including infection prevention and control and person-specific training.
· A lessons-learned system was in place; incidents were investigated and learning shared with all staff.
· Electronic monitoring was used to ensure staff stayed with people for their allocated time, with action taken on shortfalls.
HICA Homecare - Grimsby improved from Requires Improvement to Good across all five key questions at this December 2017 inspection, with 315 people receiving personal care. Residual concerns centred on inconsistent medication administration record completion across some staff teams and variable quality of person-centred information in care plans, both of which the registered manager had identified and was actively addressing.
Concerns (4)
moderateMedication management: “we found this action had been completed for some staff teams, but not all...further work and improvements were needed to ensure all teams were completing the records appropriately”
minorRecord keeping: “the quality of person-centred information varied in different people's care records. The registered manager acknowledged this and confirmed they had identified improvements were needed”
minorCommunication with families: “a small number of people told us phone calls to the office had been unanswered...Two people told us they experienced some difficulty in getting through to office staff”
minorPerson-centred care: “staff had talked to them about their preferences for their care, although we found some of this information had not always been incorporated into the care plans”
Strengths
· Staff demonstrated strong safeguarding knowledge and confidence in recognising and reporting abuse
· Robust recruitment process including DBS checks and minimum two references for all staff
· 98% call compliance in October 2017 monitored via electronic call monitoring system
· Staff received a wide range of relevant training including dementia, MCA, equality and diversity, with regular supervision and appraisal
· Very positive feedback from people: 100% of survey respondents felt treated with dignity and respect, 95% found care workers kind and caring
HICA Homecare Grimsby requires improvement overall, with recurring failures in medication record accuracy, overdue care plan annual reviews (69 outstanding), insufficient audit scale, and a delayed complaint response, all compounding governance weaknesses following rapid expansion after a local authority contract win. Strengths include a caring, well-recruited staff team, sound safeguarding practices, good supervision arrangements, and prompt post-inspection remedial action by the provider.
Concerns (6)
moderateMedication management: “we reviewed 15 people's MARs and identified gaps in 10 of these records...this gap in recording could lead to errors occurring and people not receiving their medicines as prescribed.”
moderateStaff training: “training matrix showed that a high number of staff required training in a wide range of areas including, safeguarding vulnerable adults, the Mental Capacity Act 2005, moving and handling, infection control”
moderateCare planning: “at the time of our inspection 69 annual reviews needed to be completed. This meant we could not be sure if care reflected people's needs, wishes and preferences.”
moderateGovernance: “internal audits were not completed on an appropriate scale...a maximum of seven Medication Administration Records (MARs) were audited on a monthly basis even though the service supported over 200 people”
moderateIncident learning: “no accident or incident...had been recorded in the previous 60 days...Failing to record incidents that staff witness or become aware of could lead to people not receiving the care or medical attention they require”
minorComplaints handling: “one person had not received a response to their complaint for eight weeks. The registered manager explained the investigation has been delayed due to staff sickness”
Strengths
· Staff were knowledgeable about safeguarding procedures and knew what action to take if they suspected abuse
· People were supported by suitable numbers of staff who had been recruited safely with appropriate DBS checks
· Staff received effective levels of supervision, one-to-one support, and annual appraisals
· People were treated with dignity, respect, and encouraged to maintain independence
· Detailed person-centred care plans including life histories to support meaningful engagement
Quality-Statement breakdown (15)
safe: Safeguarding and protection from abuseGood
safe: Staffing levels and safe recruitmentGood
safe: Medication managementRequires improvement
effective: Staff training and skillsRequires improvement
effective: Supervision and appraisalGood
effective: Consent and Mental Capacity Act complianceGood
effective: Healthcare access and nutrition supportGood
caring: Kindness, dignity and respectGood
caring: Supporting independence and person-centred careGood
responsive: Care planning and annual reviewsRequires improvement