HICA Homecare Chorley was rated Good across all five key questions at its November 2017 inspection, having successfully remediated two previous breaches relating to medicines risk assessments and person-centred care planning. People, staff and relatives gave consistently positive feedback about care quality, safety, responsiveness and leadership.
Strengths
· People consistently reported feeling safe and praised staff as kind, caring and professional
· Robust medicines management processes in place including storage, ordering, administration and recording, addressing previous breach
· Improved person-centred care plans with one-page profiles and detailed individual guidance, addressing previous breach
· Staff received effective induction, regular monthly supervision, annual appraisals and up-to-date training
· Strong complaints procedure with complaints logged, acknowledged and investigated; people confident issues would be addressed
HICA Homecare Chorley was rated Requires Improvement overall following a March 2016 inspection, with two regulatory breaches identified: failure to maintain adequate medicines risk assessments (Regulation 12) and care plans lacking personalisation (Regulation 9). The service performed well in effective, caring and well-led domains, with staff demonstrating competence, compassion and good knowledge of safeguarding and MCA principles.
Concerns (5)
criticalMedication management: “a number of people who were assisted with taking their medicines, some on an ad hoc basis, had no risk assessments in place within their care plan”
criticalCare planning: “We found people's care and support plans to be lacking in detail, with some of the information being task orientated and not personalised to the individual.”
moderateRecord keeping: “We found a number of risk assessments that were in place had not been reviewed in line with the services own deadlines for doing so which meant the information could potentially be out of date.”
minorSupervision / appraisal: “Some staff did tell us that whilst they did feel supported they had not had a formal face to face supervision for some time.”
minorConsent / capacity: “one person who had a diagnosis of Parkinson's did not have a capacity assessment in place.”
Strengths
· Staff were confident in identifying and reporting safeguarding concerns, with clear escalation pathways inside and outside the organisation.
· Effective recruitment policies ensured pre-employment checks including DBS clearances, references and identification were completed before staff started work.
· Staff demonstrated good understanding of the Mental Capacity Act 2005 and consent principles.
· Regular training was in place covering safeguarding, moving and handling, medication, infection control and food hygiene.
· A range of quality audit systems were in place including monthly surveys to 20% of people using the service and 20% of staff.
This focused inspection of HICA Homecare - Chorley, prompted by concerns about medicines, complaints, and governance, found both Safe and Well-Led key questions rated Good, unchanged from the previous inspection. The service demonstrated safe medication management following improvements, effective leadership, strong governance, and good engagement with people and their relatives.
Strengths
· People felt safe and staff were knowledgeable about safeguarding, with clear policies and thorough investigation of incidents.
· Medicines were managed safely; errors were investigated, staff training addressed, and no repeat errors occurred by individual staff.
· Robust recruitment procedures with all pre-employment checks completed prior to staff starting work.
· Effective infection prevention and control measures in place throughout the COVID-19 pandemic, including consistent PPE use.
· Strong governance and auditing framework with regular care record audits, spot checks, and incident learning shared at management meetings.