Haslemere Homecare Ltd

Who the service is for :

The service is registered to support older people, those with physical disabilities, those living with dementia and people with sensory impairments.

Key findings:

This service was previously rated as good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice.

The provider demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and the importance of protecting people’s rights, choice and control. Where people were unable to make specific decisions about their care, staff followed the principles of MCA, including supporting people to make decisions wherever possible, considering their best interests and using the least restrictive option. The registered manager told us, “I've got this little handout I give them staff which includes, a two-stage process of assessing capacity.”

The service had a positive learning culture, and staff were encouraged to raise concerns and report incidents. Safeguarding arrangements were in place, with staff demonstrating an understanding of their responsibilities to protect people from abuse and avoidable harm. One member of staff told us, “I would raise any safeguarding or abuse concern through the appropriate channels. If the concern involved management or I did not feel it had been appropriately addressed, I know there are alternative escalation contacts available within the staff guidance booklet.”

Staff ensured people were involved in decisions about their care and supported them to identify and manage risks in a way that promoted their safety while maintaining their independence and quality of life. One member of staff told us, “People are treated with care, and staff make sure their needs are met rather than simply completing tasks and leaving. We have time to speak with people, listen to them and find out what they want.”

Staffing levels were sufficient to meet people's needs, and staff received appropriate training, supervision and support to carry out their roles safely and effectively. Feedback from staff included, “I have never felt under pressure during calls because there were not enough staff. I do not feel that the service is short-staffed” and “The training is very in-depth and adequate. We receive both online and face-to-face training.”

Leaders undertook environmental checks in people’s homes to identify and manage potential risks, helping to ensure people and staff remained safe when care and support was delivered.
The provider managed people’s medicines safely and effectively, with appropriate systems in place for administration, recording, monitoring and auditing, and staff were suitably trained and competent to support people with their medicines. One member of staff told us, “When administering medicines, I witness the person taking their medication and record the administration on the medicine chart.”
Leaders assessed people before care and support was provided and care plans contained information about their individual needs, preferences and risks. Staff followed evidence-based guidance and worked with relevant health and social care professionals to ensure people's needs were appropriately met. One member of staff said, “I have sufficient information about people’s individual needs and how they should be supported as stated in the care plan.”

Staff ensured people's health and wellbeing were monitored, and there was evidence that changes in people's needs were identified and responded to. One member of staff told us, “We receive updates on our work phones when there are important changes. For example, if a person’s chair has broken and they need to remain in bed, the office or on-call staff will send an update to our work phones so that staff know what has happened and what support is required.”

Staff knew people well and understood their individual needs, preferences and routines. Staff provided support in a respectful and person-centred way and promoted people's dignity, privacy and independence. One member of staff said, “I encourage people to do as much as they can for themselves while providing support where needed. I give people choices and respect the decisions they make.”
Care plans provided staff with information about people's preferences, communication needs and desired outcomes. Leaders sought to respond to people's changing needs and worked with other professionals where additional support was required. A staff member told us, “At the start of a shift, I log into the system and read the person’s notes before providing care. Any changes or new information are recorded there, so I can make sure I am aware of them before supporting the person.”

Leaders had a clear shared direction and positive culture. Staff understood their roles and responsibilities and spoke positively about the management team and the care provided. Comments from staff included, “There is always someone available for me to speak to if I have any worries or concerns. I also have a monthly wellbeing check completed by someone from the office who supports staff wellbeing and mental health. It is a really supportive team, and I am very happy working there” and “I feel supported at work. I enjoy the role and feel that I am making a positive contribution by caring for people. I know I can approach the manager or on-call team if I need advice or support.”

Governance systems were in place to monitor the quality and safety of the service, including audits, checks, incident monitoring and feedback. Leaders used information from their systems to identify areas for improvement and there was evidence of learning from incidents, concerns and feedback. One member of staff told us, “I have had an incident , as it happened outside normal working hours, I reported it to the on-call service at the time and completed an incident form. My line manager subsequently followed this up with me.”