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Inspection Summary


Overall summary & rating

Requires improvement

Updated 17 January 2019

This inspection took place on 20 November 2018. We last inspected Kare Plus Enfield on 14 January 2016 and the service was rated good.

This service is a domiciliary care agency. It provides personal care to a range of adults living in their own homes with a broad range of physical, mental health and learning disability needs. At the time of this inspection the service was providing personal care to 53 people.

At the time of the inspection the acting manager was applying to CQC to be registered manager for the service. 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 and their relatives told us they were happy with the care provide and staff were kind and caring and treated them with respect.

We found discrepancies between the paper based care records based at the office and people’s homes and the electronic system staff used to prompt tasks. This included the management of medicines. There were risk assessments to guide staff in meeting some people’s needs, but not others.

The majority of staff understood their responsibilities in relation to safeguarding adults and the service had processes in place to respond to safeguarding concerns.

The management team had changed in the last year and the full range of audits were not taking place at the service, although spot checks and competency checks of staff took place regularly. We could see the service learnt from accidents and incidents.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. However, the service did not always record people’s mental capacity effectively.

Recruitment of staff was safe and staff were supported in their roles through induction, training and supervision. Staff told us they enjoyed working at the service.

People told us there were enough staff to meet their needs, who knew them well, and they were usually punctual.

Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

The service listened and responded to people’s concerns and complaints, and used these to improve the quality of care.

Inspection areas

Safe

Requires improvement

Updated 17 January 2019

The service was not always safe. There were gaps in risk assessments so staff did not always have guidance in how to manage risks.

Not all staff had followed the service’s safeguarding adults procedures.

It was not always clear what medicines support people were receiving.

Appropriate checks took place before staff were employed so recruitment was safe.

Adequate infection control processes were in place.

There was evidence the service learned from incidents to minimise reoccurrence.

Effective

Good

Updated 17 January 2019

The service was effective. Staff were supported to provide good care through comprehensive induction, training and supervision.

The service worked with health professionals to support people to have good health.

Staff understood consent and the importance of involving people in decisions about their care.

Caring

Good

Updated 17 January 2019

The service was caring. People told us staff were kind and caring to them and treated them with respect.

People were encouraged to be independent.

Responsive

Requires improvement

Updated 17 January 2019

The service was not always responsive. There were inconsistencies in care records and between paper based care records and the task based electronic care system.

There was a complaints process in place and they were dealt with in a timely manner.

Well-led

Requires improvement

Updated 17 January 2019

The service was not always well-led. Audits undertaken by the service had not identified the issues we found at the inspection.

People and their relatives told us the management team were available and the service was good.

Staff told us the management team were supportive and available.