Hope Care Agency

At the previous assessment, the provider had failed to operate effective systems and processes to assess, monitor and mitigate risks, monitor the quality and safety of the service, maintain effective governance oversight and ensure people received safe support in areas including Percutaneous Endoscopic Gastrostomy(PEG) care, diabetes management, moving and handling, medicines management and staff training.

At this assessment, we found significant improvements had been made across the service. People and their relatives consistently told us they felt safe and were satisfied with the care and support they received. People described staff as kind, caring, respectful and reliable. Relatives spoke positively about communication from the service, staffing consistency and staff understanding of people's needs and preferences.

Care plans and risk assessments had improved substantially since the last assessment. Records reviewed showed detailed, person-centred care planning that reflected people's health needs, communication requirements, personal preferences, cultural backgrounds, faith, routines and desired outcomes. Risk assessments covered identified risks including mobility, moving and handling, falls, medicines, PEG feeding, diabetes, skin integrity, fire safety and infection prevention and control.

Governance systems had also strengthened. The provider now completed regular care plan audits, medicines audits, "as required" (PRN) audits, infection prevention and control audits, spot checks, welfare calls and staff supervision arrangements. Leaders demonstrated greater oversight of service quality and were able to evidence actions taken in response to issues identified through monitoring processes.

Staff training and competency arrangements had improved significantly. Specialist training had been provided in areas including PEG feeding, diabetes, autism, dementia and mental health. Staff completed induction training, shadow shifts and competency assessments before working independently.

The provider was previously in breach of the legal regulation in relation to Good Governance (Regulation 17). Improvements were found at this assessment, and the provider was no longer in breach of this regulation. There was evidence of sustained improvements to governance arrangements, risk management systems, medicines oversight, specialist care planning and staff training.