Helping Hands Chester received a Requires Improvement rating at its first inspection, with a breach of Regulation 17 (Good Governance) identified across medication records, out-of-date care plans, missed calls, delayed safeguarding referrals, and ineffective quality monitoring systems. Staff were praised for their caring approach and the provider had implemented action plans, but sustained improvement was required across safety, responsiveness, caring, and leadership domains.
Concerns (10)
criticalMedication management: “Some people's care plans stated that family members managed and administered the person's medicines but the MAR and daily records showed that staff were administering them.”
criticalSafeguarding: “There had been a two-day delay in one safeguarding concern being reported to management who in turn had not reported the concern to the local authority until four days later.”
criticalGovernance: “Dates had been inputted onto the providers system indicating that people's care plans had been reviewed...but these had not always taken place.”
moderateMissed or late visits: “Three people had experienced missed calls which they had not always been given notice of.”
moderateCare planning: “One person's care plans stated they were continent but the daily records showed staff were supporting the person to use continence aids.”
moderateRecord keeping: “Records about medicines were not all up to date and accurate...the balance of medicines in stock or brought forward from the previous month had not always been entered onto the MAR.”
moderatePerson-centred care: “The number of different staff delivering their care was having a negative impact on the continuity of their care.”
moderateCommunication with families: “Care staff told us that they had been using their mobile phones to share information about people's needs. This method of communicating and sharing information was not secure.”
moderateLeadership: “The service did not have a registered manager...A new manager had been employed and was working one day a week.”
minorSupervision / appraisal: “They had identified gaps for some staff where records of the supervision meetings had not been maintained.”
Strengths
· Staff were described as kind, caring, patient and understanding by people and their relatives without exception.
· Staff had appropriate training including medication, safeguarding, MCA, dementia and moving and handling.
· Safe recruitment practices were in place including DBS checks, references and identity verification.
· Staff worked within the principles of the Mental Capacity Act and gained consent before delivering care.
· People's communication needs were assessed and planned for in care plans.
Quality-Statement breakdown (20)
safe: Medicines managementRequires improvement
safe: Missed and late callsRequires improvement
safe: SafeguardingRequires improvement
safe: Staffing and recruitmentGood
safe: Infection controlGood
effective: Staff training and inductionGood
effective: Supervision and appraisalRequires improvement
effective: Care needs assessment and planningGood
effective: Mental Capacity Act complianceGood
effective: Healthcare access and nutritionGood
caring: Kindness and dignityGood
caring: Continuity of careRequires improvement
caring: Confidential information sharingRequires improvement
responsive: Care plan currency and accuracyRequires improvement
responsive: Complaints handlingGood
responsive: Communication needsGood
well-led: Quality assurance and governanceRequires improvement
well-led: Registered managerRequires improvement
well-led: Duty of candour and CQC notificationsGood
Helping Hands Chester improved from 'Requires Improvement' to 'Good' across all five key questions, resolving prior breaches of Regulation 17 relating to medicines management, care planning, and governance. The service demonstrated safe staffing, personalised care, effective auditing, and a positive, open culture with strong feedback from people and relatives.
Strengths
· Medication administration records fully completed and regularly audited; staff trained and competency assessed for medicines administration
· Safe recruitment procedures with pre-employment checks completed on all staff before employment
· Care plans detailed, personalised and regularly reviewed to reflect people's individual needs and preferences
· People treated with kindness, dignity and respect; staff promoted independence and maintained privacy
· Effective governance and audit systems in place; action plans used to address identified improvements
Quality-Statement breakdown (24)
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
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
responsive: End of life care and supportGood
well-led: Continuous learning and improving careGood
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: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood