The Care Quality Commission
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Archived: The Elfrida Society - 34 Islington Park Street

Overall: Good read more about inspection ratings

34 Islington Park Street, Islington, London, N1 1PX (020) 7359 7443

Provided and run by:
The Elfrida Society

All Inspections

11 September 2017

During a routine inspection

The Elfrida Society is a local charity based in Islington for adults with a learning disability. The domiciliary care agency describes the specific element of the service that provides personal care as ”Homelink.” This currently provides support to three adults with learning disabilities within their own homes and in the local community.

This inspection was short notice, which meant the provider and staff did not know we were coming until shortly before we visited the service. At the last inspection on 2 September 2015 the provider met all of the legal requirements we looked at and was rated good.

At this inspection we found the service remained Good.

There was a registered manager in place at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our previous inspection on 2 September 2015 we made a recommendation in respect of ensuring that although people gave verbal consent, people’s written consent to their care plan was not being obtained in all cases. We also recommended that the service monitors staff supervision and appraisal. The provider had accepted these recommendations and had taken action to make improvements.

People were kept safe from harm and staff knew what to do in order to maintain their safety. Risks to people were assessed and action was taken to minimise potential risks.

People were supported to have choice and control of their lives and staff supported people in the least restrictive way possible. The policies and systems in the service also supported this practice.

Support workers were well trained and were supported through supervision and had their performance and development needs reviewed.

People’s dignity and privacy was respected and staff knew how each person wanted to be supported. People’s independence was promoted and staff encouraged people to do as much for themselves as possible. People were given information on how to make a complaint and staff supported people to use advocacy services if they wanted to.

People who used the service had support needs around their activities of daily life and engaging in the community. The service provided only small amounts of support to people with personal physical care and did not need to help anyone to take their medicines. Information contained within the four care plans we looked showed that people’s support needs were made clear.

The registered manager, along with the Homelink manager and deputy manager carried out regular audits of the service and used these as a means of maintaining high quality care. Any action that was required was taken. The provider was open and transparent in the way that they communicated with people.

Further information is in the detailed findings below.

2 September 2015

During a routine inspection

The Elfrida Society is a local charity based in Islington for adults with a learning disability. The domiciliary care agency known as Home-link provides support to adults with learning disabilities within their own homes and the local community.

This inspection was short notice which meant the provider and staff did not know we were coming until shortly before we visited the service. At our previous inspection on 15 January 2014 the provider was not meeting all of the requirements we looked at. However when we carried out a follow up inspection on 25 July 2014 we found that the provider had made the necessary improvements to the service.

At the time of our inspection the provider employed a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider.

From the discussions we had with people using the service we found that people were very satisfied with the way the service worked with them and they felt safe. There was confidence about contacting staff at the service to discuss anything they wished to.

People’s human rights were protected and the service was diligent with ensuring that the requirements of the Mental Capacity Act (2005) were complied with where these were applicable.

People who used the service had support needs around their activities of daily life and engaging in the community. The service did not provide personal physical care to anyone or helped them with taking medicines. From the four care plans we looked at we found that the information and guidance provided to staff was clear. Any risks associated with people’s care needs were assessed, and the action needed to mitigate against risks was recorded. We found that risk assessments were updated regularly.

During our review of care plans we found that these were tailored to people’s unique and individual needs. Guidance was provided to staff about the way people communicate and how they should support people, this was regularly reviewed.

We looked at the training records of all staff. We saw that required training had been undertaken and if any specialist training was necessary in order to meet people’s specific and unique needs this was also provided. We found that staff supervision was inconsistent for staff across the service and no annual appraisals had taken place, which the home-link manager accepted was in need of attention.

Staff respected people’s privacy and dignity and worked in ways that demonstrated this as being a core value of how people were treated by the service. From the conversations we had with people and records we looked at, we found that people’s preferences were recorded and that staff worked hard to ensure people’s wishes were respected.

Records which we viewed showed that people were able to complain and felt confident to do so if needed. People felt confident that any concerns they had would be listened to.

People who used the service were provided with opportunities to share their views about the quality of the service. We found that the provider took action to ensure that people were included; their views were respected and were taken seriously.

At this inspection we made two recommendations. The first was in relation to improvements to the consistency of staff supervision and appraisals. We also made a recommendation in respect of ensuring that although people gave verbal consent, people’s written consent to their care plan was not being obtained in all cases. Please refer to the “Effective” section of this report for the details regarding each of these recommendations.

25 July 2014

During an inspection looking at part of the service

At this follow up inspection we sought to answer one of our five questions; Is the service well led? This was due to action the provider was asked to take as the result of our previous inspection on 15th January 2014.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with one of the management staff at the service and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service well-led?

During this inspection we found that spot checks were being carried out and these had begun in April 2014. Between then and this inspection a total of 34 spot checks had been carried out for the 36 people who were using the service and plans were in place to visit the other's. We looked at a sample of the records of spot checks already completed. We found these included speaking with people using the service, staff supporting them and discussing the effectiveness of the service.

The records we looked at, a sample of spot checks and two care plans and risk assessment updates were accurate and had been completed in a timely way. This meant that the provider had continued to ensure that people's personal support records, and those required for day to day management of the service, were relevant, up to date and reflected the current support needs for people using the service.

15 January 2014

During a routine inspection

We spoke with five people who used the service. They confirmed that their care plans had been discussed with them prior to them agreeing to the care and treatment plan.

The records we read showed that support, care and treatment was planned in line with what had been expressed in the referral forms and during visits the service had made to people's homes. One person who used the service told us 'I am in control of my care plan, it's my time.'

People were supported to be able to eat and drink sufficient amounts to meet their needs. The records we read had details of people's physical profiles and medical history including their weight and cholesterol.

Appropriate arrangements were in place in relation to the recording of medicine. Details of people's medications were found in the records that we read. People were self-medicating from blister packs and this had been risk assessed.

Staff told us 'we get support from the office whenever we need it.' The people we spoke with who used the service told us they received a 'good' service.

The provider did not have an effective system to regularly assess and monitor the quality of service that people receive. The registered manager told us that quality audit checks were not being carried out due to 'time pressures'.

People's personal records including medical records were accurate and fit for purpose.Records were kept securely and could be located promptly when needed.

20 March 2013

During a routine inspection

At the time of the inspection thirty people were using the domiciliary care service. We met or spoke with eight of them or their family members.

People were very positive about the service, indicating that they were provided with the care that they needed, and were given choices about the support they received. People told us 'I'm very happy,' 'They offer you the support you need,' 'I'm quite happy with them,' 'They are always on time,' 'I've had no problems at all,' and 'It's the best thing that I've ever done - taking up the Homelink service.'

People had formed good and supportive relationships with staff and management. They were supported to access healthcare professionals when needed, and were also supported to undertake varied activities in their own homes and in the community. Staff received appropriate supervision and training, and quality assurance procedures were being developed for the agency. However there was room for improvement in the recording of risk assessments and other records for people using the service to ensure that their needs were met safely.