Archived: Age Concern - Tower Hamlets

Updated 11 December 2019

The inspection

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

Inspection team

The inspection team consisted of 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 care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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.

Notice of inspection

This inspection was announced. This inspection was announced. We gave the service half a day’s notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback

from the local authority quality monitoring team who work with the service. We used the information the

provider sent us in the provider information return. This is information providers are required to send us with

key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager and the project manager. We reviewed a range of records. This included two people's care records and their medicine records. We looked at two staff files in relation to recruitment, staff supervision and training. A variety of records relating to the management of the service were reviewed.

After the inspection

We spoke with one person’s family member or friend. We spoke with one care worker. We continued to seek clarification from the provider to validate evidence found. For example, we looked at training data and quality assurance records.

Updated 11 December 2019

About the service

Age Concern – Tower Hamlets is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to the whole population. Not everyone using Age Concern – Tower Hamlets receives a regulated activity; 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, it was providing a service to two people.

People’s experience of using this service and what we found

A relative or friend told us that their loved one was safe with the carers, but the service was not run safely. The provider had not always identified risks to people who used the service or developed guidance for staff about how to reduce risks where these were identified. The provider had not always reviewed and updated people's risk assessments to reflect their changing needs.

People were at risk of not getting their medicines as prescribed because the system to check medicine records was not effective and medicines were being administered by staff who had not been trained or assessed as competent to carry out the task.

The provider lacked robust systems and processes to ensure the quality and safety of service. The registered manager had recently expanded their other services and did not have enough time or support to continue providing the same quality of service found at the last inspection. The relative or friend of a person using the service did not feel confident their concerns would be listened to and acted upon. Not all staff had received training needed to support them carrying out their role.

Where full care records were in place they were personalised to reflect people's preferences. Staff developed caring relationships with people and supported their diversity and independence. People were supported to eat and drink in line with their preferences and were supported to access healthcare services if required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was outstanding (published 7 April 2017). At this inspection we found the rating had not been sustained and the provider was in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified three breaches in relation to safe care and treatment, staffing and training, and good governance at this inspection. We have made a recommendation in relation to person - centred care.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.