About the service The Roof Support Services UK Ltd is a domiciliary care agency. It provides care and support to people in their own homes in the London Boroughs of Brent and Harrow. The provider supports people living with mental health needs, dementia or who have physical disabilities. At the time of our inspection the service was providing care and support to 34 people. 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. The provider had one location from which they managed this service.
People’s experience of using this service and what we found
People told us that they felt safe. However, the provider had not always assessed the risks to people's health and well-being or done all that was reasonably practicable to lessen those risks.
People received support with their medicines, but the provider did not always ensure this was managed safely. The provider had not assessed staff as competent to give the medicines support being asked of them, medicines support records were not sufficiently detailed, and there was not always information for staff on when to help people take medicines they only needed occasionally.
Staff received training and supervision, but staff did not receive training on how to support people with their specific needs, such as epilepsy or dementia. The provider did not always maintain up to date employment and induction records for all care staff.
People's care and risk management plans set out the care tasks they required help with, but these plans did not provide personalised information about people and their preferences for how they liked to be supported. The provider did not always record how staff were to meet people’s communication needs.
There were systems in place to monitor the quality of the service and recognise when improvements were required. These were not sufficiently robust to have identified the issues we found in relation to the management of risks to individuals' health and wellbeing, medicines management, and care planning.
We received mixed feedback from people and their relatives about using the service. Some people said staff were caring and treated them with respect, other people felt this was not always the case.
Staff sometimes provided extra support and assistance to people when this was not part of people's contracted care arrangements.
Staff received regular supervision. Staff found the managers approachable and told us they felt supported.
Adult social care professionals told us managers were responsive to and worked in partnerships with statutory agencies to meet people’s needs.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This inspection was a planned inspection based on the previous rating.
Rating at last inspection
The last rating for this service was good (published 3 Feb 2017).
Enforcement
We have identified five breaches of regulations at this inspection. These were in relation to managing medicines and risks to people’s safety, person-centred care, staff training and recruitment, and having effective systems in place to monitor and improve the quality of the service.
We have served requirement notices for the breaches of regulations in relation to managing medicines and risks to people’s safety, person-centred care, and staff training and recruitment. We have served a warning notice for the breach of regulation in relation to having effective systems in place to monitor and improve the quality of the service.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. We may inspect sooner if we receive any concerning information about the quality and safety of the service.