Ealing Office

Updated 3 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was conducted by two inspectors and two Expert by Experience who made phone calls to people and their relatives after the site inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. However, they were not present on the day of the inspection.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 16 November 2022 and ended 17 December 2022. We visited the location’s office on 18 November 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, including the action plan the provider sent to us following the previous inspection saying what they would do and by when to improve. We also sought feedback from the local authorities who work with the service. We used all of this information to plan our inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We took this into account in making our judgements in this report.

During the inspection

We spoke with the operations manager and branch office lead and we reviewed a range of records. This included 10 people's care records, 4 staff records and multiple medicines records. A variety of records relating to the management of the service, including audits were also reviewed. As part of the inspection we spoke with 7 people using the service, 9 relatives and 4 care workers to get feedback of their experience of the service.

Updated 3 March 2023

About the service

Ealing Office is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. The majority of people had their care funded by either the London Borough of Ealing or the London Borough of Hounslow. At the time of our inspection 94 people were using the service. Not everyone who used the service received personal 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.

People’s experience of using this service and what we found

During the inspection we found risk assessments were not always robust enough and medicines were not always managed safely. This could put people at risk of harm.

The provider had procedures for managing incidents, accidents, safeguarding alerts and complaints, and quality monitoring processes in place, to help monitor and improve service delivery. However, these were not always effective, as they had not identified the areas where improvements were required that we found during the inspection.

The provider was not always consistent in maintaining person centred care records.

People were not always supported to have maximum choice and control of their lives and the provider could not demonstrate people were always supported in their best interests. While the provider had policies and systems, these were not always robustly implemented. We have made a recommendation for the provider to consistently implement the principles of the MCA.

Notwithstanding the above, people were satisfied with the care provided and felt safe. Overall, the provider followed safe recruitment practices to help ensure suitable people were employed. Staff received appropriate training to meet people’s care needs.

People were supported by the same staff who provided consistency and were satisfied with the punctuality of their care workers.

People using the service and staff told us the manager team were approachable and responded to concerns.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 9 December 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last four consecutive inspections including this inspection.

Why we inspected

We carried out an announced comprehensive inspection of this service on 29 and 30 July 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, staffing and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ealing Office on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care, person centred care and good governance at this inspection.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.