Independent Home Care Team

People’s experience of using this service:

¿ People said they felt safe. There were safeguarding policies and procedures in place and staff had a clear understanding of these procedures.

¿ Appropriate recruitment checks took place before staff started work and there was enough staff available to meet people’s care and support needs.

¿ The service had procedures in place to reduce the risk of infections.

¿ Assessments of people’s care and support needs were carried out before they started using the service.

¿ Staff had received training and support relevant to people’s needs.

¿ People were supported to maintain a balanced diet.

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

¿ People were treated in a caring and respectful manner.

¿ People had been consulted about their care and support needs.

¿ There were procedures in place to make sure people had access to end of life care and support if it was required.

¿ People knew how to make a complaint if they were unhappy with the service.

¿ The provider worked in partnership with health and social care providers to plan and deliver an effective service.

¿ The provider took people and staffs views into account through satisfaction surveys. Feedback from the surveys was used to improve the service.

¿ Staff enjoyed working at the service and said they received good support from the registered manager and deputy manager.

At our last inspection of the service 22 March 2018 we found improvements were required in relation to how medicines were managed, risks to some people’s health and safety were not being assessed appropriately, some people’s care records were not person centred and the provider’s audits were not always consistently effective in identifying issues and driving improvements.

At this inspection we found that improvements had been made in these areas. The provider had taken steps to make sure medicines were managed safely, people’s health and safety was being assessed appropriately, people’s care records were person centred and the provider’s audits were effective in identifying issues and driving improvements.

Rating at last inspection: Requires Improvement (Report was published on 23 May 2018).

Why we inspected: This was a planned inspection based on previous rating.

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

There was a registered manager in post. 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.

During this inspection, we found one breach of the Health and Social Care Act 2008. Risk assessments did not clearly reflect the potential risks to people which meant risks were not being appropriately identified and managed which could result in people receiving unsafe care. Arrangements in place to manage people’s medicines were not sufficient to ensure people received their medicines safely and as prescribed

We also found further improvement was required as people’s care plans were not person centred or planned in a way that catered for their individual needs and requirements. The provider’s systems for assessing and monitoring the service were not robust and had not identified the issues we found during this inspection.

Staff had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.

The service is part of a new pilot hospital discharge scheme run by the local authority to help local hospitals. People and relatives spoke positively about the care and support they received from the service under this scheme.

People and relatives told us that they were confident that staff had the necessary knowledge and skills they needed to carry out their roles and responsibilities. Staff spoke positively about their experiences working for the service.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People gave consent to the care and support they received. Relatives and healthcare professionals were involved in making decisions for people in their best interests where this was appropriate.

Feedback from people and relatives showed positive relationships had developed between people and staff members and people were treated with dignity and respect. Staff were aware of the importance of treating people with respect and dignity.

Staff had been carefully recruited and provided with induction and training to enable them to support people effectively. They had the necessary support, supervision and appraisals from management.

The provider had procedures in place for managing complaints, and people and relatives knew how to raise concerns. Management staff worked in partnership with other organisations to help achieve positive outcomes for people. Staff were very prompt in reporting to the service if there was a change in people’s needs which enabled people to receive the appropriate support where needed.

Independent Home Care Team is a domiciliary care agency situated in the London borough of Greenwich. The agency provides care and support for adults living in Greenwich, Bexley and Bromley boroughs. They provide care and support to adults and older people, people living with dementia, physical disability and or sensory impairment.

At the time of our inspection there were approximately 80 people using the service and there was a registered manager in post. 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.

There were systems in place that ensured people received their care on time and people were kept safe. There were policies and procedures in place for safeguarding adults from abuse. Appropriate recruitment checks took place before staff started work and staffing levels were appropriate to meet the needs of people using the service.

Risks to people were identified and assessed to reduce any risk of harm, and there were suitable arrangements in place to manage foreseeable emergencies. Where people required support with their medicines, we saw there were robust arrangements in place to ensure medicines were managed and administered safely.

Staff received supervision, appraisals and training appropriate to their needs and the needs of people who they supported to enable them to carry out their roles effectively. There were processes in place to ensure staff new to the service were inducted into the service appropriately.

There were systems in place which ensured the service complied with the Mental Capacity Act 2005 (MCA 2005). This provides protection for people who do not have capacity to make decisions for themselves. People’s nutritional needs and preferences were met and people had access to health and social care professionals when required.

People told us they were treated with dignity and respect and they were consulted about their care and support needs. People were provided with information about the service when they joined and we saw that people were provided with a copy of the provider’s ‘service user guide’ which was kept in people’s homes.

People told us the care and support they received respected their wishes and met their needs. People’s support, care needs and risks were identified, assessed and documented within their care plan. People’s needs were reviewed and monitored on a regular basis. People were provided with information on how to make a complaint and who to refer to if they were unhappy with the outcome. The service worked with health and social care professionals and with local authorities who commissions the service to ensure people’s needs were met.

People told us they thought the service was generally well run and staff told us they received good support that enabled them to do their jobs effectively. There were systems in place to ensure consistency and quality was maintained whilst supporting people in the community. There were effective processes in place to monitor the quality of the service. People were provided with opportunities to provide feedback about the service.