Archived: Focus Care Link - Tower Hamlets

Focus Care Link provides personal care and support for people living in their own homes. At the time of the inspection there were 159 people using the service in the borough of Tower Hamlets.

There had not been a registered manager in post since June 2016. The branch manager operated the day to day running of the service and was present on the second day of our inspection and told us they had applied for the registered managers post 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.

Risk assessments were in place and updated to show how risks could be managed and reduced, however risks related to people’s home environment were not always fully assessed to reduce the likelihood of harm. People were encouraged to remain independent and care plans showed staff how this should be done. Reviews of people’s care needs had been carried out in collaboration with relatives and the professionals involved in their care where appropriate.

Allegations of abuse had been investigated and safeguards put in place to protect people from harm but the Care Quality Commission (CQC) had not been notified of these incidents. Care visits were monitored to provide people with their calls on time.

Some people were supported to take their medicines, however some records did not fully include the guidance that staff required to make certain medicines were managed safely. Medicines training had been completed by the staff and their competency was regularly checked.

Thorough background checks were carried out on staff before they were employed by the provider. Staff were equipped with the skills and knowledge they required to ensure people received safe care. Staff spoke positively about the provider and told us the service was well led.

The provider followed the legal requirements in relation to the Mental Capacity Act (MCA) 2005.

People’s dietary requirements were met but did not include their food preferences. Communication between the provider and health professionals was frequent to make sure people had access to healthcare services when they needed this.

Care was carried out in a dignified and respectful manner. Staff took the time to speak with people about their preferred pastimes and they told us staff were attentive, helpful and caring.

Quality assurance systems were in place to assess the quality of care; however these did not always identify the shortfalls we found. Surveys were carried out to capture people’s feedback and action was taken to improve how the provider delivered their service.

Systems were in place to monitor and respond to complaints and people had information that contained guidance for them about how to report concerns, however information was not provided in an accessible format.

We have made two recommendations about the safe management of medicines and the accessibility of information. We found one continuous breach of regulations about the notification of safeguarding incidents. You can see what action we asked the provider to take at the back of the full version of this report.

At the time of our inspection 96 people were using the service and 63 care workers were employed to provide care. The service had a registered manager in place. 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.

People were protected by procedures in place to safeguard them. Staff had knowledge and training about how to identify abuse and keep people safe.

Risks to people in relation to their care and welfare were assessed, however their risk assessments were incomplete and did not all state what actions would be taken to minimise and manage identified risks.

People’s needs were assessed and care planned prior to them using the service. Whilst people’s basic care needs were identified, support plans were not personalised to include people’s preferences about how they wished to receive care, including their likes and dislikes.

People using the service were at increased risk of receiving inadequate care as care plans did not always cover all aspects of people’s needs and wishes and how to meet them.

Staff were sufficient in numbers and skill mix to safely meet people’s needs. Staffing levels were

assessed and staff allocated to ensure people’s safety based on their individual needs. All staff were vetted prior to commencing work. Criminal record checks were completed for all staff and essential recruitment documents and records were in place.

Staff received an induction when they began work and training to ensure they had the knowledge and skills they needed to meet people’s needs. Staff were supported through regular meetings with their manager.

People were supported to maintain their nutrition and had access to ongoing healthcare support. The provider kept records of regular contact with health and social care professionals.

Staff had received some training in the Mental Capacity Act 2005 and were aware of the need for people to consent to their care and support. However the provider’s practice was not always in keeping with the requirements of the Mental Capacity Act 2005 to ensure that people’s rights were protected.

People using the service and their relatives had positive experiences of the care they received and said staff were caring and friendly. However some people mentioned that regular staff were more skilled and more knowledgeable about their needs and how to meet them compared with replacement staff and we had more favourable comments about regular staff than replacement staff in relation to their caring approach.

The provider followed procedures to ensure people received their medicines safely.

The provider took prompt action in response to complaints or issues of concern. Where concerns were raised from people using the service or their representatives, these were addressed. Where concerns were substantiated, these were addressed and action taken to ensure improvements were made. Staff monitored people following any concerns to ensure that things had improved and that the matter had been resolved.

The provider had failed in the legal responsibility to inform CQC of significant incidents or events affecting the safety and welfare of people.

Staff spoke well of the management and said they were available whenever they needed them and that they received good training and support. The provider had systems in place to monitor the quality of service. However these systems were not always effective in identifying and addressing shortfalls found during the inspection to ensure the ongoing improvement and development of the service.

We found breaches of regulations relating to consent to care, safe care and treatment, person centred care and the legal duty to notify CQC of significant incidents. You can see what action we told the provider to take at the back of the full version of the report.

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