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Archived: Carterhatch Domiciliary Care Service Good

The provider of this service changed - see new profile


Inspection carried out on 17 and 18 November 2015

During a routine inspection

This inspection took place over two days, 17 and 18 November 2015. The provider was given 48 hours’ notice because the location provides a domiciliary care service. Carterhatch Domiciliary Care service is provided by the London Borough of Enfield. It provides care and support for around 70 people in their own home. The service works with people living with dementia, learning disabilities, and people with autistic spectrum disorder, older people and people with sensory and physical impairment.

The service was last inspected 14 November 2013 and was meeting all the regulations inspected. There was a registered manager in post. A registered manger is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of law; as does the provider. The registered manager was not present during the inspection.

People were involved in decisions about their care. Where people were unable to have input, best interests meetings and decisions were recorded. Procedures relating to safeguarding people from harm were in place and staff understood what to do and who to report it to if people were at risk of harm. Staff had an understanding of the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

There were individualised care plans written from the point of view of the people that were supported. Care plans were detailed and provided enough information for staff to support people. We saw that care plans were regularly reviewed and updated as changes occurred.

Risk assessments gave staff detailed guidance and ensured that risks were mitigated against in the least restrictive way. Risk assessments were reviewed and updated regularly.

People received a continuity of care. The provider always tried to ensure that the same care workers looked after people. This promoted good working relationships with people who used the service.

There was a system in place to monitor any missed visits. Missed visits were investigated and followed up. The provider had begun to introduce a new electronic monitoring system to monitor visits.

People were encouraged to have input into their care and the service. The provider ran a quarterly service user forum where people were encouraged to discuss issues and say what they did and did not like about the service they received.

People and relatives said that they were treated with dignity and respect. Staff were able to give examples of how they ensured that they promoted dignity. People were encouraged to be as independent as possible.

Staff received regular, effective supervision and appraisals and attended monthly team meetings. Senior staff completed regular monitoring of care staff via monitoring visits.

We found that there was an open culture that encouraged staff and people to discuss issues and ideas, though team meetings and service user forums. Team leaders supported care staff on a daily basis.

Staff had received training on medicines administration and people were supported to take their medicines safely. Medicines were accurately recorded on medicine administration (MAR) sheets.

Audits were carried out across the service on a monthly and quarterly basis that looked at things like, medicines management, health and safety and quality of care. There was a complaints procedure as well as incident and accident reporting. Where areas for improvement were identified, the registered manager used this as an opportunity for change to improve care for people.

Inspection carried out on 14 November 2013

During a routine inspection

People, those people significant to the person and staff told us how people gave their consent to care and treatment. Some people's consent was obtained with the involvement of people significant to them if required. One person told us "Staff respect me".

Care plans and risk assessments had been planned and reviewed with the person and other professionals. Staff described to us people's individual needs and how they provided care. One person told us �I have a good time going out.� One relative told us �the carers are part of the family. Since they have been coming my relative is like a different person.�

Records showed that care staff had also provided regular feedback to the manager on people�s changing needs. This resulted in one person being referred to their GP and Occupational Therapist for a walk in shower which had been approved. There was continuity of care between staff.

The provider was taking appropriate steps to ensure that there were sufficient numbers of suitably qualified, skilled and experienced persons employed to safeguard the health, safety and welfare of people.

People who use the service and their representatives were asked for their views about their care and treatment. Records showed that quality audits had been undertaken and actions identified were followed through.

Inspection carried out on 1 November 2012

During a routine inspection

We spoke with people who use the service and their relatives. People told us that staff were respectful towards them and always spoke to them appropriately. People told us their expressed wishes were acted upon by staff.

The majority of people said that visits by staff took place on time and that staff attended for the agreed length of time.

The agency was in the process of developing the care plans that currently included critical call times and personal care tasks and some personal goals.

People confirmed they felt safe. People spoken with knew how to contact staff and raise concerns.The service had systems in place to help protect people.

People felt that staff were trained well enough to look after their needs. One person said "they do everything I ask them to do." Another person said "they are wonderful they listen to you."

There was a complaints procedure in place. Complaints were covered in the staff handbook. Staff were aware that they had to report complaints to the manager.