Date of Assessment: 4 and 9 November 2024. Hadi Care Leeds provides personal care to people living in their own homes in the community. Haddi Care Leeds is 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. This allows us 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. During our last inspection the service was in breach of regulations. This assessment found the service had made improvements and is no longer in breach of regulations. Staff now supported people with their medicines safely. Governance systems were now robust, people’s records were audited frequently to ensure risks were identified and mitigated. There were enough staff to be able to support people safely. Staff had extensive training and supervision and were able to access additional qualifications. Incident and accidents were reviewed and changes implemented as needed. Staff understood and managed people’s risks, and people were kept safe and protected from harm. People were involved in their care assessment processes. People were asked for consent, and any decisions were clearly recorded. People were treated with kindness and compassion. Staff protected their privacy and dignity. People had choice in their care and were encouraged to maintain relationships with family and friends. People knew how to give feedback and were confident the service took it seriously and acted on it. People received fair and equal care and treatment. People were involved in planning their care. Leaders were supportive. People and staff with protected characteristics felt supported. There was a culture of continuous improvement within the service.
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Hadi Care Ltd was rated Requires Improvement overall at its first inspection, with breaches of Regulation 12 (safe care and treatment) and Regulation 17 (good governance) identified relating to unsafe medicines management, incomplete risk assessments and care plans, and ineffective audit and incident-review systems. The service demonstrated notable strengths in person-centred, culturally responsive care, staff training and support, infection control, and communication, with people and relatives reporting positive experiences.
Concerns (8)
criticalMedication management: “Staff were not always recording whether they had checked if people had eaten prior to receiving these medicines. Guidance was not in place for 'as required' medicines.”
criticalCare planning: “One person had health conditions which impacted on their ability to eat...There was no nutritional risk assessment completed to show how staff should reduce this known risk.”
criticalGovernance: “Governance systems were not effective...resulted in a lack of oversight for accident and incidents, medications, care plans and risk assessments.”
criticalGovernance: “The registered manager failed to notify the Care Quality Commission of two accidents which were reportable under the statutory notification requirement.”
moderateCare planning: “Another person had a recent change to their moving and handling requirements. However, their care plan had not been updated to reflect the new requirements.”
moderateIncident learning: “Incidents and accidents were recorded, but were not consistently reviewed or analysed for patterns or trends.”
minorMissed or late visits: “One relative said, 'Very often they are late, we asked for a specific time, but they don't come at that time.'”
minorComplaints handling: “We found one example of a complaint received where staff had not been informed of the new protocols agreed.”
Strengths
· Staff received regular supervisions, appraisals and an individualised induction programme.
· Strong infection prevention and control practices with adequate PPE supplies and compliance spot checks.
· Safe recruitment practices in place, including recruiting staff with specific language and dialect skills to meet communication needs.
· Person-centred culture with staff demonstrating caring values and supporting people's cultural and spiritual needs.
· Effective communication approach, including recruiting staff with specific language skills and developing audio care plans in people's spoken language.
Quality-Statement breakdown (18)
safe: Using medicines safelyRequires improvement
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
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: 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
responsive: Improving care quality in response to complaints or concernsGood
responsive: Planning personalised care to ensure people have choice and control; End of life care and supportGood
responsive: Meeting people's communication needsGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; Continuous learningRequires improvement
well-led: How the provider understands and acts on the duty of candourRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffGood