We undertook an assessment of Helping Hands Hungerford between 22 February to 12 April 2024. Helping Hands Hungerford is a domiciliary care agency providing personal care to people in their own homes. The service supported older people, younger adults, people living with dementia, people with a sensory impairment and people with a physical disability. The service had systems in place to ensure the delivery of safe, effective and person-centred care. There were systems in place to ensure safeguarding concerns were investigated and reported as appropriate. The provider had made improvements. The provider now notified us of significant events and other incidents that happened in the service without delay. There were now systems in place to check the quality of the service, and the registered manager, provider and staff understood their roles. Systems and processes to monitor quality and safety in the service were now established and operated to ensure compliance with legal requirements. However, safe recruitment practices were not always followed. Following the assessment the provider took immediate action to address these shortfalls. The service was well led. The registered manager fostered a culture of learning and maintained close oversight of the service.
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Helping Hands Hungerford received an overall rating of Requires Improvement at its first inspection, with breaches of Regulation 17 (good governance) and Regulation 18 (notification of incidents) identified in the safe and well-led domains. Care delivery, staffing and person-centred practice were rated Good, with people and relatives consistently reporting kind, respectful and personalised support.
Concerns (6)
criticalGovernance: “Systems and processes to monitor quality and safety in the service were not established and operated effectively to ensure compliance with legal requirements. Regulation 17 (1)(2)(a)(c)”
criticalSafeguarding: “The provider had failed to ensure CQC was consistently notified of reportable events without delay such as allegations of abuse. Breach of Regulation 18.”
moderateIncident learning: “There was no evidence that the management team investigated the incidents or accidents effectively or they analysed themes and trends in the accident and incident reports.”
moderateMedication management: “Medicine administration records (MAR) contained several unexplained omissions...no audits were completed for one person and only one audit had been completed for the other person.”
moderateCare planning: “There was no evidence that the management team updated peoples care plans following a change in their needs. For example, following a fall where the person required medical support.”
minorMissed or late visits: “The registered manager was due to complete regular audits for monitoring late or missed visits...audits were only completed in February and March 2021.”
Strengths
· People felt safe with staff and reported being treated with kindness, care and respect.
· Staff had completed mandatory training including safeguarding, MCA, manual handling and food hygiene, with annual refreshers.
· Care plans were personalised, written from the person's perspective, and included life histories, preferences and risk assessments.
· Consistent staff allocation promoted continuity of care and strong relationships between staff and people.
· Robust recruitment process with all staff files containing necessary evidence in line with legal requirements.
Quality-Statement breakdown (21)
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
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: Ensuring consent to care and treatment in line with law and guidanceGood
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: Improving care quality in response to complaints or concernsGood
well-led: Managers and staff being clear about their roles, quality performance, risks and regulatory requirementsRequires improvement
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: Engaging and involving people using the service, the public and staffGood