16 May 2018
During a routine inspection
At the time of the inspection, 26 people were using the service who were living in the London Boroughs of Bromley Greenwich and Lewisham.
The service has a registered manager. 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.
At the last inspection on 26 February 2016, we found the registered manager did not always review staff performance each year through an appraisal. We asked the registered manager to make improvements in staff appraisals and this action has been completed.
At this inspection we found that people experienced late care visits and were not informed of this promptly. We also found that sufficient improvements were not taken to ensure staff were regularly supervised. We have made two recommendations regarding the monitoring of missed and late visits and staff supervisions.
The registered provider had guidance that helped staff explore the principles of safeguarding adults from abuse. Staff were able to identify abuse and take action to keep people safe from harm.
Risks to people were identified and recorded in risk assessments. Risk management plans were developed from this information and used as a tool for staff to manage those risks for people.
Enough staff were employed to care for people. When people required more than one member of staff to support them, this was provided. Safer recruitment procedures were used to recruit suitable skilled and experienced staff.
People had their medicines safely. People had their required medicines as prescribed by their GP. Staff were assessed as competent and safe to complete this task.
Staff had an induction, training and appraisal. Although staff completed supervisions these were not completed on a regular basis. Staff had access to regular training and appraisal to help them in their roles.
The Mental Capacity Act 2005 (MCA) principles were understood by the registered manager. Staff completed training in MCA which improved their understanding and knowledge of caring for some under MCA. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People gave staff their consent to care before staff provided care and support.
Staff prepared meals for people according to their needs. People said they enjoyed meals staff provided which met their individual preferences. Staff also completed shopping tasks when people required this.
Health care services supported people with their health needs. People had access to a GP so that their health needs were reviewed and monitored. Staff accompanied people to appointments if this was what people wanted.
Assessments focused on the needs of people using the service. Care records were person centred and included details of the care and support people needed to maintain their health and wellbeing. People were involved in the assessment of their needs. People made care decisions which were recorded and reviewed on a regular basis.
People could make decisions about their care and how their wanted it carried out. End of life decisions were also recorded in people’s care records which guided staff on how to support people effectively.
Staff treated people with respect, kindness and were helpful. People said staff respected their privacy and provided care in a dignified way.
The registered provider had an infection control policy in place. Staff followed this guidance and used personal protective equipment to reduce the risk of infection.
The registered provider had a complaint policy. The complaint process in place allowed people to make a complaint about an aspect of their care and support.
Staff told us they enjoyed working for the service and said they carried out their jobs effectively. The registered manager completed a review of the quality of care at the service. People gave their opinions of the quality of care and support they received.
The registered manager fulfilled the requirements of their registration with Care Quality Commission (CQC). The service informed CQC of concerns and incidents that occurred at the service.
The registered provider had developed partnership working with health care professionals and accessed services for people to help them maintain their health and well-being.