Peoples Care Limited

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

At the time of the inspection the provider was supporting 86 people with personal care.

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

Although the issues we found did not directly impact the level of care and support people received, improvements were needed with the level of detail and information of the care records in place.

Key records related to people’s care and support lacked sufficient detail or were not available at the time of the inspection. Important information and guidance for care staff to follow related to people’s care and support was not always recorded or in place.

Safer recruitment practices were not always followed. The providers monitoring processes were not always effective as they had not picked up all the issues we found during this inspection. The provider had failed to notify us about all the incidents that had occurred across the service.

People were not consistently supported to have maximum choice and control of their lives as the policies and systems in the service were not always up to date. However, staff supported people in the least restrictive way possible.

People and their relatives were happy with how their care and support was being delivered. People had regular care staff where some had worked with people for many years. People told us they felt safe and staff had a good understanding of their needs.

People and their relatives told us the flexible nature of the care had a positive impact on their lives and helped them to remain as independent as possible.

People and their relatives praised the positive benefits of having staff who spoke their first language to aid communication and to understand their cultural needs.

People were supported by staff who felt valued and supported in their role. Staff spoke positively about the management team and felt proud working for the organisation.

People and their relatives were positive about the management of the organisation and told us the management team were available, flexible and worked hard to accommodate their needs.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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 the service was good (published 30 March 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We had also received anonymous concerns in relation to allegations care was not being provided due to misuse of direct payments, but the funding authority was still being invoiced. A direct payment is the amount of money that the local authority has to pay to meet the needs of people and is given to them to have control and choice over who they choose to provide their care.

As a result, we shared this information with the relevant local authority Fraud Team and they carried out their investigation at the same time as our inspection.

We found no evidence during this inspection that people were at risk of harm from these allegations.

Enforcement and Recommendations

We have identified 3 breaches in relation to safe care and treatment, recruitment practices and good governance.

We have made two recommendations about how people’s communication needs are recorded and how the provider ensures they are working within the principles of The Mental Capacity Act 2005 (MCA).

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This service 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 older adults and younger disabled adults. At the time of the inspection they were supporting 22 people in the London Boroughs of Tower Hamlets, Hackney, Southwark, Newham, Redbridge and Barking and Dagenham. Not everyone using Peoples Care Limited receives 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.

All of the people using the service were funded by the local authority and were able to choose their service provider with the use of direct payments. A direct payment is the amount of money that the local authority has to pay to meet the needs of people and is given to them to purchase services that will meet their needs.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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’s risks were managed and care plans contained appropriate risk assessments which were updated regularly when people’s needs changed. The registered manager had produced guidance for care workers to follow that had been translated into Bengali to ensure they understood how to keep people safe.

The provider had a robust recruitment process and staff had the necessary checks to ensure they were suitable to work with people using the service. People had regular care workers to ensure they received consistent levels of care.

The provider had a medicines policy in place where care workers were only allowed to prompt people with their medicines. Improvements had been made since the last inspection on how people’s medicines were recorded.

People who used the service and their relatives told us that they felt safe using the service. All staff had a good understanding of how to identify and report any concerns and were confident that any concerns would be investigated and dealt with.

Care workers received an induction and training programme to support them in meeting people’s needs. They shadowed more experienced staff before they started to deliver personal care and were introduced to people before starting work with them. Staff felt supported and were happy with the supervision they received and the content of the training available.

The provider understood the legal requirements of the Mental Capacity Act 2005 (MCA) and was aware of the processes to follow if they had concerns about people’s capacity. People and their relatives told us that staff respected their decisions and gained consent before carrying out care tasks.

We saw that care workers notified the management team and people’s relatives if they had any concerns about people’s health. We also saw people were supported to maintain their health and well-being through access to health and social care professionals, such as occupational therapists, advocates and district nurses.

Care workers were aware of people’s dietary needs and food preferences and this was highlighted in people’s care records.

People were actively involved in decisions about their care and support, in accordance with their wishes. People and their relatives told us that advocacy support and staff being able to interpret on their behalf helped them in their day to day lives.

People and their relatives told us that staff were kind and compassionate, respected their privacy and dignity and promoted their independence. There was evidence that language and cultural requirements were considered when carrying out the assessments and allocating care workers to people using the service. We received positive feedback from people, their relatives and staff about the importance of being able to communicate with each other in their own language.

People were involved in planning how they were cared for and supported. An initial assessment was completed from which care plans and risk assessments were developed. Care was personalised and the provider listened to people to be as flexible as possible when trying to meet their needs.

People were provided with information on how to make a complaint and felt comfortable raising concerns if they needed to. There were surveys in place to allow people and their relatives the opportunity to feedback about the care and treatment they received. These documents were provided in both English and Bengali.

People using the service and their relatives told us that the service was well managed and they had recommended the service to other people in the community. Staff spoke highly of the support they received to carry out their responsibilities.

There were processes in place to monitor the quality of the service provided and to understand the experiences of people who used the service. This was achieved through regular communication with people and care workers, supervision and a programme of other checks and audits, including telephone monitoring and spot checks. We saw that improvements had been made and learning had taken place since the last inspection.

Peoples Care Limited is a domiciliary care agency which provides personal care and support to people in their own homes. At the time of our visit the service was providing personal care and support to 14 people in the London Boroughs of Tower Hamlets, Southwark and Barking and Dagenham. All of the people who used the service and the care workers who supported them used Bengali to communicate with each other.

All of the people using the service were funded by the local authority and were able to choose their service provider with the use of direct payments. A direct payment is the amount of money that the local authority has to pay to meet the needs of people and is given to them to purchase services that will meet their needs (as assessed by the local authority).

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The provider had a medicines policy in place where care workers were only allowed to prompt people with their medicines. Staff had completed basic training in medicines and knew what to do if they had any concerns. However care records were not always clear about people’s medicines and were not always recorded in people’s daily logs.

People’s risks were identified and care plans contained risk assessments to reduce the likelihood of people coming to harm, however guidance for care workers was not always accurately recorded and was given verbally during shadowing visits.

The provider had a robust staff recruitment process and staff had the necessary checks to ensure they were suitable to work with people using the service. People had regular care workers to ensure they received consistent levels of care.

People and their relatives told us they felt safe using the service and care workers understood how to protect people from abuse. Staff were confident that any concerns would be dealt with appropriately. All staff had received training in safeguarding adults and had a good understanding of how to identify and report any concerns.

Care workers received an induction training programme to support them in meeting people’s needs effectively and were always introduced to people before starting work with them. They shadowed more experienced staff before they started to deliver personal care independently and received regular supervision from management. They told us they felt supported and were happy with the supervision they received, although supervision records were not documented.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and were aware of the processes to follow if they had concerns about people’s capacity. Care workers respected people’s decisions and gained people’s consent before they provided personal care.

Care workers were aware of people’s dietary needs and food preferences and this was highlighted in people’s care records. Care workers told us they notified the management team and people’s relatives if they had any concerns about people’s health. We also saw people were supported to maintain their health and well-being through access to health and social care professionals, such as occupational therapists, advocates and social services.

People told us that staff respected their privacy and dignity and promoted their independence. There was evidence that language and cultural requirements were considered when carrying out the assessments and allocating care workers to people using the service.

People and their relatives told us care workers were kind and caring and knew how to provide the care and support they required. Care workers understood the importance of getting to know the people they supported and were able to communicate with them in their own language.

People were involved in planning how they were cared for and supported. The registered manager or team of supervisors visited people in their own homes to carry out an initial needs assessment, from which care plans and risk assessments were developed. There was evidence that the provider listened to people about who they wanted to work with them.

People and their relatives knew how to make a complaint and were able to share their views and opinions about the service they received. There were quality monitoring visits, phone calls and regular satisfaction surveys in place to allow people and their relatives the opportunity to feedback about the care and treatment they received. Feedback could be given in people’s own language.

The service promoted an open and honest culture. We received positive feedback about the management of the service and staff felt well supported and were confident they could raise any concerns or issues, knowing they would be listened to and acted upon.

Procedures were in place to check standards of care and the satisfaction of people who used the service, although not all records were being documented. Audits on daily logs did not always pick up the issues we found during the inspection. The registered manager acknowledged this and told us they were in the process of developing new translated forms to help their staff with recording information.

We identified one breach of the Regulations in relation to good governance and made one recommendation in relation to the safe management of people’s medicines. You can see what action we told the provider to take at the end of the full version of this report.