Archived: Jewish Care North London and Hertfordshire Home Care Service

Updated 11 April 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was completed by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of domiciliary care service. Their role involved talking with people using the service and their families on the phone.

Service and service type:

This domiciliary care agency provided support with activities regulated by the Care Quality Commission to 18 people at the time of this inspection. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of the inspection the registered manager for this service was working at another of the provider’s services. The day to day management of the service was being managed by a registered manager from another of the provider’s services. We have referred to this person in this report as the interim manager.

Notice of inspection:

We gave the service 48 hours’ notice of the inspection visit because it is small and the interim manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

What we did

Before the inspection:

• We checked for any notifications made to us by the provider and the information we held on our database about the service and provider. Statutory notifications are pieces of information about important events which took place at the service, such as safeguarding incidents, which the provider is required to send to us by law.

• We reviewed the Provider Information Record (PIR). The PIR provides key information about the service, what the service does well and the improvements the provider plans to make.

• We also reviewed the action plan sent to us following the last inspection. This set out the actions the service planned to take to address the breaches of the regulations we found.

During the inspection visits to the office on 4 & 6 March 2019:

• We looked at three staff recruitment records.

• We looked at seven care records including risk assessments and medicines administration records.

• We spoke with four care staff, a care manager, the interim manager and the service manager.

• We looked at supervision, training, accidents and incidents, complaints and compliments.

• We looked at management processes to audit the quality of the service.

After the inspection visits:

• We telephoned two people who used the service and six relatives to get their feedback.

• We were sent additional management documentation including auditing information and updated risk assessments following the inspection.

Updated 11 April 2019

About the service:

• This service is a domiciliary care agency.

• It provides personal care to a range of adults living in their own homes, of Jewish faith, with a broad range of physical and mental health needs.

People’s experience of using this service:

• People and their relatives told us they felt safe and were happy with the care provided.

• People told us staff were able to look after them well and had the skills to care for them.

• There were enough staff to meet people’s needs; some people told us staff did not always tell them when they were running late.

• Care records promoted person centred care, but the service was not recording medicines administration and support safely at the time of the inspection. The service have made improvements since the inspection.

• Risks identified with caring for people were recorded for the majority of concerns, but the service did not always provide enough detail for staff to support people with significant mental health needs. The service has made improvements in this area since the inspection.

• People and their relatives told us they provided feedback on the service, and they thought it was well run. However, we were concerned at the lack of accurate contemporaneous recording of medicines administration records and lack of effective provider oversight of medicines management. We were of the view the service was not always well led.

• The service met the characteristics for a rating of "Requires Improvement" in two out of five key questions we inspected. We found there was a breach of the regulations in relation to governance of the service. Therefore, our overall rating for the service after this inspection was "Requires Improvement". We have also made a recommendation in relation to the staff understanding of the Mental Capacity Act 2005.

More information is in our full report.

Rating at last inspection: At our last inspection, the service was rated "Requires Improvement". Our last report was published on 27 March 2018. At the last inspection we found two breaches of the regulations related to the safe management of medicines and the governance of the service.

Why we inspected: This inspection was part of our scheduled plan of visiting services in line with the “Require Improvement” rating, to check the safety and quality of care people received.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.