Focused inspection found Haven247 Healthcare Limited had improved from Requires Improvement to Good across Safe, Responsive and Well-led, with previous breaches of Regulations 17 and 18 now resolved. People reported feeling safe, well treated and supported by effectively deployed staff working under robust governance and recruitment systems.
Strengths
· Safe and robust recruitment procedures with full DBS, references and employment history checks in place
· Electronic call monitoring system used to ensure visits are on time and of agreed length
· Medicines administered safely with staff competency assessed and PRN protocols in place
· Effective infection prevention and control with appropriate PPE use
· Person-centred care plans reflecting current needs, including end of life wishes where agreed
Quality-Statement breakdown (14)
safe: Staffing and recruitmentNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
responsive: End of life care and supportNot rated
responsive: Meeting people's communication needsNot rated
responsive: Planning personalised care to ensure people have choice and controlNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
well-led: Managers and staff being clear about their roles and understanding quality, performance and risksNot rated
well-led: Duty of candourNot rated
well-led: Working in partnership with othersNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
First inspection of newly registered domiciliary care agency supporting four people, rated Requires Improvement overall with one breach of Regulation 17 (Good governance) due to ineffective quality monitoring, recruitment, supervision and call monitoring systems. Caring was rated Good with positive feedback on staff kindness, while end-of-life care planning and electronic call monitoring required improvement.
Concerns (6)
criticalGovernance: “Failure to assess, monitor and improve the quality and safety of the service people received is a breach of regulation 17 (Good governance)”
criticalStaff competency: “Robust recruitment checks did not always take place before staff started work... employment histories were not always completed in full”
moderateSupervision / appraisal: “The provider did not have a supervision policy in place and staff were not supported through regular supervision. One staff member said, 'I haven't had one yet.'”
moderateMissed or late visits: “staff attended the person's home 77 minutes late. There were no notes recorded on the ECM system at the time as to why the care call was late.”
moderateRecord keeping: “staff file audits did not identify that application forms were not completed in full regarding employment and qualification histories”
minorEnd-of-life care: “People's care plans did not have their end of life wishes and preferences documented in their care plans.”
Strengths
· People said they felt safe and that staff were responsive
· Medicines were safely managed with completed Medicine Administration Records
· Appropriate safeguarding systems in place and staff trained in safeguarding
· Staff were kind, caring and treated people with dignity and respect
· Effective complaints system in place
Quality-Statement breakdown (21)
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Using medicines safelyNot rated
safe: Learning lessons when things go wrongNot rated
safe: Preventing and controlling infectionNot rated
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choicesNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
effective: Supporting people to eat and drink enough with choice in a balanced dietNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: End of life care and supportRequires improvement
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Working in partnership with othersNot rated