About the service This service is a domiciliary care agency and is based in the London Borough of Barking & Dagenham. The service provides personal care to adults in their own homes. 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 our inspection, the service provided personal care to 38 people.
People’s experience of using this service
Medicines were not being managed safely as the provider was not aware staff were administering medicines to people. Sufficient risk assessments were not in place to ensure people received safe care at all times. Some staff had not received training to ensure they could perform their roles effectively. Regular supervisions had not been carried out to ensure staff were supported to carry out their roles.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Robust pre-assessments systems were not in place to ensure people received support in a person-centred way. Care plans were brief and were not person centred. Quality assurance systems were not in place to identify shortfalls and take prompt action to ensure people always received safe care. Adequate safeguarding systems were not in place to ensure people were protected from abuse. We have made a recommendation in this area.
There was no system in place to evidence that people had been involved in the decisions about the support they received. People’s beliefs and religions had not always been captured in care plans.
People and relatives told us that people were safe when supported by staff. Pre-employment checks had been carried out to ensure staff were suitable to support people. People and relatives told us staff were punctual and systems were in place to monitor time keeping. Systems were in place for infection control and to learn from lessons following incidents.
People received care from staff who were kind and compassionate. Staff treated people with dignity and respected their privacy. Staff had developed positive relationships with the people they supported. They understood people’s needs, preferences, and what was important to them.
Complaints had been managed in a timely manner. Systems were in place to obtain feedback from people and relatives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 21 August 2017 and this was the first inspection.
Why we inspected
This was a planned inspection based on when the service started to provide the regulated activity of personal care. The service registered with the CQC on 21 August 2017 and started to provide the regulated activity of personal care on December 2018.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We have identified breaches in relation to risk assessments, medicine management, training and supervision, need for consent, person centred care and good governance at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
The overall rating for this service is ‘Inadequate’ and the service is therefore in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.