Unit 11 Also known as Promise Care

Unit 11 is a domiciliary care agency and is based in the London Borough of Barking & Dagenham. The service provides personal care to people in their own homes. 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 service was supporting 15 people with personal care at the time of the inspection.

People’s experience of using this service

Risks assessments were not always robust to ensure people received safe care. Medicines were not being managed safely. Care plans did not include people’s preferences with personal care to ensure they received person centred care. Communication plans were not in place to ensure staff communicated with people effectively.

Robust audit arrangements were not in place to ensure shortfalls could be identified and prompt action taken.

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

Staff were aware of how to safeguard people from abuse. Systems were in place to prevent and minimise the spread of infections when supporting people. Pre-employment checks had been carried out to ensure staff were suitable to work with people. Systems were in place to ensure staff attended calls on time.

Staff had been trained to perform their roles effectively. Staff supervisions were regular to ensure staff were being supported at all times.

People received care from staff who were caring and had a good relationship with them. Staff respected people’s privacy and dignity. People were encouraged to be independent and to carry out tasks without support.

Systems were in place to ensure feedback was received from people on their care.

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 on 6 December 2018.

Why we inspected

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

The overall rating for the service is now Requires Improvement. This is based on the findings at this inspection.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Unit 11 on our website at www.cqc.org.uk.

Enforcement and recommendations

We have identified breaches in relation to need for safe care and treatment, person centred care and good governance at this inspection.

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 and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The service had a registered manager. 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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.

Some risks to people were not always robustly managed. We found some care plans did not contain suitable and sufficient risk assessments to effectively manage risks. We made a recommendation in this area.

Pre-employment checks had not been carried out in full to ensure staff were suitable to provide care and support to people safely. Two references had not been obtained prior to staff providing personal care to people, which was against the providers recruitment policy. We made a recommendation in this area.

People were given choices with meal times. However, care plans did not include people’s preferences with meals.

People’s ability to communicate were recorded in their care plans. However, there was no information on how staff should communicate with people and particularly how staff would make information accessible to people.

Audits had not identified shortfalls with risk assessments and care plans to ensure prompt action could be taken and people received high quality care. The registered manager told us that audits did not take place as they had been supporting people for a short time but showed us evidence of audit forms that would be completed.

Staff were aware of how to identify abuse and knew who to report abuse to, both within the organisation and externally.

Medicines were being managed safely. Records showed that people had received their medicines on time.

There were arrangements in place to ensure staff attended care visits on time. Staff told us they had time to provide person centred care and the service had enough staff to support people.

Staff had been trained to perform their roles effectively. People were being cared for by staff who felt supported by the management team.

Pre-assessment forms had been completed to assess people’s needs and their background before they started using the service.

Staff were aware of the principles of the Mental Capacity Act [2005]. Staff sought people’s consent before supporting them.

People were supported to access healthcare if needed. Staff knew if people were not feeling well and who to report to.

People’s privacy and dignity were respected by staff. Relatives told us that staff were caring and they had a good relationship with them.

No complaints had been received but people and relatives had access to complaint forms and staff were aware of how to manage complaints.

Relatives and staff were positive about the management team.