13 December 2018
During a routine inspection
Age UK Kensington and Chelsea is a domiciliary care agency which provides the regulated activity of ‘personal care’ to people living in their own houses and flats in the community. Not everyone using Age UK Kensington and Chelsea receives regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with personal care; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection the provider was providing services for 47 people, which included 27 people who received personal care.
A registered manager is a person who has registered with CQC 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 the time of the inspection the manager had appropriately applied to CQC for registered manager status.
We found the provider did not always have detailed risk assessments in place to identify risks to people’s safety and well-being. For example, staff had recorded their concerns about a person’s skin integrity in their daily visit sheets but this was not reflected in the person’s risk assessment.
Recruitment practices did not always demonstrate that references for staff were checked to ensure they were genuine, to ensure that people who used the service consistently received care and support from staff with appropriate skills and background to work for the provider.
People who used the service felt safe with staff, who had received training to protect people from the risk of abuse and harm. Staff were also trained to protect people from the risk of cross infection and were provided with personal protective equipment to use at people’s homes.
Staff told us they felt well supported by the management team. Records demonstrated that staff had received induction, mandatory training, individual and group supervision, and annual appraisals. Team meetings were also held by the manager to bring staff together for discussions about their work and development.
Where required staff supported people to meet their nutritional needs and attend health care appointments. People were supported to meet their medicine needs where this formed part of their agreed care plan. Staff informed us they reported any concerns about a person’s health to their line manager so that applicable health care professionals could be informed.
The provider understood how to protect people’s rights and supported people to make choices about their care and support in line with their capacity to do so. People were supported in a respectful manner that promoted their dignity. Staff understood how to meet people’s religious and/or cultural needs. People and relatives liked receiving their care from a limited number of conscientious and reliable care staff that they got to know well.
The care plans were being reviewed and updated by the manager to ensure that people’s needs and wishes were described in a more individual and detailed manner. We noted that some plans needed more written guidance for staff to provide care and support that was tailored to people's unique needs and aspirations. People and relatives were given information about how to make a complaint. We saw that where complaints and safeguarding investigations had occurred, the provider carried out its own analysis to identify and address shortfalls in how the service operated.
People and relatives expressed they thought the service was well managed and they liked the openness of the manager. We saw that quality assurance systems were in place but the provider had not picked up on specific issues that needed to be improved on, that we found during the inspection. For example, we found that the on-call records needed to be written in a more precise and professional manner. The provider had created its own action plan and fully acknowledged that improvements were needed.
There were well developed working relationships with other local services, which enabled the provider to continually develop its own knowledge and offer people who used the service new opportunities to meet their health care needs and social interests.
We found three breaches of regulation in relation to safe care and treatment, recruitment and good governance. You can see what action we asked the provider to take at the end of the full version of this report.