Harbour Home Care

CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided

Risks were identified, assessed and recorded. However, we could not see any evidence of regular reviews of identified risks. The registered manager stated they had made visits to people's homes and carried out reviews, but it was not possible to find the records of these visits.

Care plans were completed for each person and contained details of some people's needs and preferences. However, care plans did not have a consistent format. Each one we reviewed included slightly different documents. Information was not held securely, with pages found loosely in a folder of card. This meant it was easy for pages to fall out, get mislaid or misfiled. Some important information was not always included in care plans, to direct and guide staff. For example, if the person was living with a long-term condition such as diabetes or had an increased risk of injury.

Confidential personal information was held in care plans, some presented a security risk. For example, the combinations to the key safes, used by staff to access keys to a property where the person was unable to open the door themselves. We asked the registered manager to take immediate action to remove this information and re-set all the combinations for safety reasons.

Harbour home care had a stable team of four staff. Recruitment procedures were in place. However, personnel files were also not held in an organised consistent format, with loose pages not securely held together. This meant information was difficult to find and could easily become mislaid.

Some people received support from staff to buy things. For example, staff regularly purchased food and general shopping for some people. There was not a robust process in place for staff to follow when recording these transactions. There was no management oversight of these financial records.

We were told staff supported some people to take their medicines. We asked to see the Medicine Administration Records (MAR) which staff completed to evidence their actions. The MAR's were not completed in an appropriate manner; however, it became evident upon further discussion that the staff were not actually prompting or administering any medicines, merely checking if medicines had been taken. We advised the provider to amend these care plans.

There was no evidence in any care plans of the registered manager having obtained signed consent from people, who had capacity, to indicate they agreed to receive care, and to the content of their own care plan. There were no records in the care plans of any Lasting Power's of Attorney (LPA's) held by people they supported.

When staff arrived at a planned visit but unexpectedly found no one at home, there was no consistent process in place for staff to escalate this concern, to help ensure the person was safe and well.

The service had not implemented any quality assurance systems to monitor the quality and safety of the care provided. One relative told us, "Since we started the visits, several months ago, no one has been in touch with us to check how it is going." One person who received a service from Harbour Home Care confirmed that "I have not met the registered manager. No-one has been to ask me how things are going. Although I am quite happy."

The registered manager did not have a robust system in place to manage information. Some paper care records were held in people's homes and there were some copies in the office, although these records did not always tally. There were also electronic copies of care plans and assessments, but this information was inconsistently organised and could not be provided for review. Throughout this inspection the registered manager struggled to find information requested.

People were supported by staff who had been appropriately trained and were skilled in their role. However, staff did not receive formal supervision or appraisal in accordance with the providers policy. Staff told us they felt well supported. Comments included, "(Deputy Manager) is amazing. We don't have formal supervision, but I can get what support I need" and "I can't recall having had any supervision but we can talk on the phone if needed."

Staff understood the importance of respecting people's diverse needs and promoting independence. Some people using the service, had issues with their capacity. However, no assessments had been carried out or best interest meetings held when decisions were made on behalf of another person. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; although the policies and systems used in the service did not always support this practice.

Spot checks were carried out by the deputy manager to monitor staff performance.

People told us they felt safe with staff. There were systems to help protect people from abuse and to investigate any allegations, incidents or accidents.

People's care and support needs were assessed before they started using the service. People received support to maintain good health and were supported to maintain a balanced diet where this was part of their plan of care.

For more information, please read the detailed findings section of this report. If you are reading this as a

separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk