We carried out our assessment of this service between 22 April 2025 and 2 May 2025. Havesters Care Ltd provides domiciliary care to people in their own homes. CQC only assesses where people receive personal care. At the time of this assessment, the service was providing personal care to 96 people. We had previously inspected this service on 30 August 2022 when we had rated the safe, effective, responsive and the well domain as requires improvement. Overall, the service was rated requires improvement. During this inspection, we saw improvements had been made. This means that the services overall rating also improved and is now rated good. This was a planned assessment of all quality statements under the key questions. We carried out the site visit on 2 May 2025. We gave the service 5 days’ notice of the inspection and requested information to support the inspection prior to our visit.
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Havesters Care Ltd remained Requires Improvement with a continued breach of Regulation 17 (good governance) due to inadequate quality assurance, inconsistent risk assessments and care plan detail, and ineffective analysis of feedback. Staff felt undervalued and unheard by leadership, and people reported mixed experiences around timeliness, communication and complaints handling, though medicines, safeguarding and recruitment were managed safely.
Concerns (12)
criticalGovernance: “The provider failed to have effective systems in place to assess, monitor and improve the quality and safety of the service, to act on feedback from service users, to monitor and mitigate risks”
criticalRecord keeping: “The failure to maintain an accurate, complete and contemporaneous record in respect of each service user was an ongoing was a breach of Regulation 17”
moderateCare planning: “not all people's care plans contained sufficient detail to mitigate known risks. Although some people's care plans did have detailed information about risks, this was not consistent.”
moderateLeadership: “six out of seven staff spoken with felt underappreciated and undervalued. One staff member said, 'The [registered] manager is unapproachable, we have a meeting but nothing changes.'”
moderateSupervision / appraisal: “some staff told us they did not always feel supported or listened to if they did raise concerns. One staff member said, 'We [staff] have raised concerns with the [registered] manager but we are not listened to and nothing changes.'”
moderateMissed or late visits: “Staff don't always turn up on time and they don't call and let us know anything about it... The times [of visits] they [staff] come are not good, sometimes they come an hour after they have already been”
moderateStaffing levels: “feedback we received from staff indicated they did not have enough time to travel to each person in between visits.”
moderateConsent / capacity: “some people who had a diagnosis of dementia and required their medicines administering to them, did not have a decision specific MCA in place for this.”
moderateMedication management: “one person was allergic to penicillin and there was insufficient detail for staff to recognise signs and symptoms should the person have an allergic reaction and what action they should take.”
minorComplaints handling: “people and their relatives did not all know how to raise any concerns they might have about their care and support.”
minorStaff training: “Honestly I thought it [the induction] was too quick for me to get in the field. There was not much time for me to grasp everything I needed to know.”
minorEnd-of-life care: “While some people's care plans captured their end of life wishes, this was not consistent.”
Strengths
· Safe recruitment procedures with robust pre-employment and DBS checks
· Staff trained and competency-assessed in safe administration of medicines
· Effective infection prevention and control, including PPE use
· Staff understood safeguarding and reported concerns appropriately
· Accidents and incidents reported and reviewed by the registered manager
Quality-Statement breakdown (20)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
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
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Duty of candourNot rated
well-led: Continuous learning and improving care; working in partnership with othersNot rated