Date of assessment: 3 to 5 March 2026. Holistic Homecare Ltd is a Domiciliary Care Agency, providing support and personal care to people in their own homes. Staff supported people of varying ages with different health needs. At the time of our assessment 22 people were receiving support from the service. We carried out this assessment due to the age of the rating. The service has been rated good. An assessment has been undertaken of a specialist service that is used by autistic people or people with a learning disability. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgments about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. The service was meeting the elements of Right support, right care, right culture. The service had strong systems for safeguarding, risk management, medicines, infection control, and safe staffing. People told us they felt safe. Accidents and incidents were reviewed and monitored. People were supported by enough and staff were trained and recruited safely. People’s needs were assessed, and care plans contained details about people’s needs, wishes and preferences. Staff worked well with professionals to support good health outcomes. The service regularly reviewed people’s goals and outcomes were monitored to improve practice. Staff were responsive to people and centred their support around people’s choices, routines, and preferred activities. Communication was available in accessible formats. People were involved in reviews, and concerns were responded to promptly. Leaders were available, supportive, and promoted a positive culture based on clear values. Governance systems were robust, with regular audits and continuous improvement processes in place. Staff felt able safe to speak up, included, and valued. The service worked well with partners and the wider community. Systems were in place to gain feedback from people and staff, to enable the provider to drive continuous improvements in the safety and quality of care provided.
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Holistic Homecare Ltd was rated Good across all five key questions at this announced inspection on 15–18 December 2017, having successfully remediated all three regulatory breaches identified at the previous October 2016 inspection. The service demonstrated particular strength in culturally competent, person-centred care for a diverse multicultural client group, with consistent staffing, robust governance and very positive feedback from people using the service.
Strengths
· People felt safe and spoke very positively about care workers being respectful and kind
· Cultural and linguistic match between staff and service users from diverse multicultural backgrounds
· No missed visits reported; reliable and consistent staffing with regular care workers assigned
· Previous regulatory breaches in Regulations 12, 17 and 19 fully remediated at this inspection
· Robust medicines administration with external pharmacist training and competency spot checks
Holistic Homecare Ltd received an overall rating of Requires Improvement at its first inspection, with breaches of Regulations 12, 17 and 19 identified relating to unsafe recruitment practices, insufficient safeguarding training, poor medicines care planning, and ineffective governance systems. The service demonstrated notable strengths in culturally competent, caring practice and strong family and staff satisfaction, but requires significant improvements to its safety and oversight processes.
Concerns (9)
criticalSafeguarding: “induction training that staff received covered a large range of information in a short time. This meant that no subject was covered in real detail.”
criticalStaff competency: “provider failed to ensure persons employed were of good character and had the qualifications, competence, skills and experience necessary for the work to be performed”
criticalRecord keeping: “references that had been provided for one staff member appeared to have been written by the same person, despite being from different, national companies.”
criticalMedication management: “medicines people were prescribed were not recorded in their care plans and there was a lack of clarity about the role of the staff when supporting people with their medicines.”
criticalGovernance: “systems used to monitor the quality and safety of the service were not always effective...managers had not picked up all the areas of concern we identified at the inspection.”
moderateCare planning: “care plans were not always person centred and lacked detail...very little person centred information about what was important to people in how staff provided their care and support.”
moderateStaff training: “Staff training was not recorded in any central register to help the provider to keep track of the training undertaken by staff or when updates were due.”
moderateSupervision / appraisal: “There was no central register of when staff supervisions and annual appraisals had taken place.”
minorConsent / capacity: “service did not provide any, more specific training on the MCA...three people's contracts were due for review in June 2016 and we saw no evidence that this had taken place.”
Strengths
· Staff communicated with people in their own language and understood their cultural backgrounds, reducing isolation for hard-to-reach service users.
· People's relatives consistently reported feeling their family members were safe and well cared for by consistent, familiar care workers.
· Care staff respected people's privacy, dignity and independence, and promoted person-centred values in day-to-day practice.
· The service was flexible and responsive to changing needs, with management readily accessible to families and professionals.
· Accessible complaints procedure available in multiple languages; relatives felt comfortable raising concerns.
Quality-Statement breakdown (19)
safe: Recruitment proceduresRequires improvement
safe: Medicines managementRequires improvement
safe: Safeguarding trainingRequires improvement
safe: Staffing levelsGood
safe: Risk assessmentsRequires improvement
effective: Staff trainingRequires improvement
effective: Supervision and appraisalRequires improvement