Date of inspection: 3 July to 18 July 2025. Happy Home Care Services Ltd is a domiciliary care agency supporting people with personal care living in their own homes.This inspection was prompted due to the length of time since our last inspection. At the time of the inspection, 26 people were receiving support from the service. The provider had learnt lessons from the previous inspection, and we found the service had made the improvements required.Recruitment processes were robust, and audits continued to identify where improvements were needed. Staff were knowledgeable and new how to report any safeguarding concerns and incidents were investigated with actions taken to mitigate future risks. People were safely supported by staff with their medicine administration. Risk assessments were in place to guide staff on how best to support people and their needs. Staff involved people and their relatives in decisions and reviews of care. The service supported people to access external health care professionals to try to promote their well-being. Staff respected people’s choices and understood how to obtain consent. The leadership team were passionate about their responsibility to care for people and the staff team told us they felt supported.
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Happy Home Care Services Ltd improved from Inadequate to Requires Improvement overall following a focused inspection, successfully addressing prior regulatory breaches in safeguarding, medicines management, care records, and governance. The single remaining concern is incomplete recruitment referencing practices, with a recommendation issued but no ongoing breach of regulation found.
Concerns (2)
moderateGovernance: “We were not assured processes and procedures to ensure safe recruitment at the service were in place. There were insufficient references for some staff.”
moderateLeadership: “The registered manager understood their role and regulatory requirements. However, we were not assured about safe recruitment requirements.”
Strengths
· No missed visits reported; staff communicated delays to relatives proactively
· Medicines managed and administered safely with competency assessments in place
· Care plans and risk assessments kept up to date and reflective of individual needs
· Staff received safeguarding training and people felt safe with the service
· Effective infection control measures including appropriate PPE use
Quality-Statement breakdown (19)
safe: Staffing and recruitmentRequires improvement
safe: Assessing risk, safety monitoring and managementGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Learning lessons when things go wrongGood
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: 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
responsive: Planning personalised care to ensure people have choice and controlGood
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: Managers and staff being clear about their roles, quality performance, risks and regulatory requirementsRequires improvement
well-led: Engaging and involving people, promoting a positive person-centred cultureGood
well-led: How the provider understands and acts on the duty of candourGood
First inspection of Happy Home Care Services Ltd found breaches of Regulations 12, 13 and 17 relating to medicines management, safeguarding, risk assessment and governance, resulting in an overall Inadequate rating and placement in special measures. Care was praised as kind and dignified, but record-keeping, audit systems and managerial understanding of statutory notifications placed people at risk of harm.
Concerns (14)
criticalMedication management: “staff were not routinely completing Medicine Administration Records (MAR'S) when supporting people with their medicines. Therefore, it was difficult to assess if medication had been given as prescribed.”
criticalMedication management: “Person centred guidance was not in place for 'as required' medicines. This meant staff did not have information about the specific circumstances when these medicines should be given.”
criticalCare planning: “one person's daily notes entries indicated the person wore a falls bracelet... However, there was no falls risk assessment or mobility care plan in place.”
criticalSafeguarding: “we saw an example of a safeguarding concern, that was not reported to either the local safeguarding team or CQC. The registered manager and nominated individual were not clear about their role in making such reports.”
criticalGovernance: “The provider's quality assurance systems and processes were not effective and had not enabled them to assess, monitor and improve the quality and safety of the service.”
criticalIncident learning: “we saw evidence not all accidents and incidents were being recorded and there was no overall analysis identifying any patterns or trends which could be addressed”
criticalRecord keeping: “Care records were not always complete. This meant there was not always evidence to demonstrate risks to people's health and safety were being effectively assessed, monitored and mitigated.”
criticalLeadership: “The registered manager did not always fully understand their role and responsibilities, particularly what they were required to notify CQC and local authorities about”
moderateCare planning: “Care plans were not always reviewed and updated as people's needs changed.”
moderateEnd-of-life care: “people did not have end of life plans in place which considered their wishes and preferences. This put people at risk of receiving care which was not personalised to their individual needs and wishes.”
moderatePerson-centred care: “this knowledge was not always captured within care records. This put people at risk of receiving care which was not always personalised to their needs.”
moderateConsent / capacity: “We saw that some people's mental capacity assessments were not robust enough.”
moderateCommunication with families: “People had no individual communication plans that detailed effective and preferred methods of communication”
minorComplaints handling: “Failure to log the informal complaint meant a missed opportunity to use lessons learnt to drive improvement to people's care.”
Strengths
· Staff were kind, caring and patient; people were treated with dignity and respect
· Sufficient staff to provide consistency of care; calls were not missed and people were informed of delays
· Safe recruitment procedures including DBS checks were followed
· Good infection prevention and control practice with plentiful PPE stocks
· New staff received an induction, shadowing and care certificate training
Quality-Statement breakdown (24)
safe: Assessing risk, safety monitoring and managementInadequate
safe: Using medicines safelyInadequate
safe: Systems and processes to safeguard people from the risk of abuseInadequate
safe: Learning lessons when things go wrongInadequate
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 lawRequires improvement
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietRequires improvement
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
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 preferencesRequires improvement
responsive: End of life care and supportRequires improvement
responsive: Meeting people's communication needsRequires improvement
responsive: Improving care quality in response to complaints or concernsRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careInadequate
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 candourInadequate
well-led: Engaging and involving people using the service, the public and staffRequires improvement