Herts at Home was rated Requires Improvement overall following a focused inspection of Safe and Well-led, downgraded from Good at the previous 2019 inspection. Key failures included a breach of Regulation 17 (Good Governance) due to ineffective quality assurance systems, gaps in fire safety training, inconsistent agency staffing, and a senior management culture staff described as closed and unsupportive.
Concerns (7)
critical
Governance
: “The provider had not effectively used their quality assurance systems and processes to assess, monitor and improve the quality and safety of the service. This was a breach of Regulation 17.”
moderateStaffing levels: “There were not always enough suitably experienced, skilled and qualified permanent care workers deployed to meet people's individual support needs.”
moderatePerson-centred care: “People said the agency staff seldom read the care plans to gain an understanding about how to provide person centred and consistent care.”
moderateStaff training: “Herts at Home training matrix did not reflect fire safety training and care workers confirmed they had not received this training.”
moderateLeadership: “Care workers advised the management culture from the top was not open and transparent, senior management were not approachable and did not serve to support them to do their roles.”
moderateIncident learning: “Despite these regular checks the senior management team were not aware of some of the issues identified through feedback with people, their relatives and staff.”
minorCommunication with families: “The office never ring us to say the care worker is running late. I have had to ring before now just to check we were going to have a care visit as it was so late in the day.”
Strengths
· Safe and effective recruitment practices were followed to help ensure recruits were of good character and sufficiently experienced.
· Care workers were trained and had their competencies to safely administer medicines checked by senior staff.
· Care workers had received infection control training and performance was assessed at local management spot checks.
· Incidents and accidents were recorded, investigated by local managers and reviewed by the senior management team.
· People felt safe and relatives were confident people were protected from abuse and avoidable harm.
Quality-Statement breakdown (10)
safe: Staffing and recruitmentRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement
well-led: Engaging and involving people using the service, the public and staff; Continuous learning and improving careRequires improvement
well-led: Managers and staff being clear about their roles, quality performance, risks and regulatory requirementsRequires improvement