Caring Hands East London Ltd

Caring Hands East London Ltd is a domiciliary care agency providing personal care to adults in their own homes. The service provides support to people living with a range of needs including people living with dementia, an eating disorder, a physical disability or a sensory impairment. At the time of this inspection, the service was providing personal care to 87 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.

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

People and their relatives were satisfied with the care provided by Caring Hands East London Ltd. People were involved in making decisions about their care. There were systems in place to help safeguard people from the risk of abuse. Risks to people were assessed and monitored. Recruitment processes were robust and there were enough staff working at the service. The service had permanent staff and used trained bank staff when additional staff was required. Medicines were managed safely. Staff were provided with personal protective equipment (PPE) and received training to help protect people from the risk of cross infection.

There were systems in place to ensure lessons were learned and shared with staff when things went wrong. People's needs were assessed before they began using the service so the provider knew they could meet their needs. Staff received inductions and shadowed experienced staff members before they began supporting people, so they knew what to do when they started working with people.

People's communication needs were met. People were supported with activities to avoid them feeling isolated. There were systems in place to investigate complaints and make improvements to the service. Systems to monitor the quality and safety of the service were in place. Staff reported having a positive relationship with the provider and felt communication was effective.

Quality monitoring systems allowed for the effective monitoring of the service by the provider. People and staff were pleased with how the service was managed. The management team was open to change and improvement and wanted what was best for people. The nominated individual and the deputy manager knew about their duty of care and regulatory requirements. People were able to engage with the service and provide feedback about the care. Staff could provide input into the service through meetings and supervision.

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 this service was good (published 3 August 2021)

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe, responsive and well-led only for those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Follow up

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

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes. The service did not have a registered manager. However, there was an acting manager who had submitted their application to be registered with the CQC. A registered manager and the nominated individual are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

Our inspection was announced. We gave the service 48 hours' notice of the inspection. This was because it is a domiciliary service and we needed to be sure that a member of the management team was available to support us with the inspection.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed the information we already held about this service. This included details of its registration, previous inspection reports and any notifications of significant incidents the provider had sent us. We used all of this information to plan our inspection.

During the inspection

We spoke by telephone with one person using the service, the nominated individual, acting manager, human resources manager, an administrator and three care staff. We reviewed documents and records related to people's care and the management of the service. We also reviewed five people's files, which included risk assessments. We sampled 10 staff files to check the provider's staff recruitment and support processes. We looked at other documents such as quality assurance records.

After the inspection

We continued to seek clarification from the provider to validate evidence we found such as looking at action plans and the training matrix. We also spoke with five relatives of people and five staff.

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

People and their relatives told us they were happy with the service and staff working there. They felt the service was managed well. However, we found the registered manager did not always notify us of concerns raised about their service.

People using the service told us they felt safe when staff visited them. Staff knew what action they should take and how to report any concerns they had. Risks to people were assessed and reviewed regularly.

The provider undertook all necessary checks before new staff began work for the service. There was sufficient staff to provide people’s care.

Systems were in place to make sure people received their medicines as prescribed, which included staff training. Staff had been trained in a variety of areas and were supported to maintain their skills through supervision, appraisals and refresher training. People had access to appropriate health professionals when required and staff monitored and responded when their health needs changed. People were supported to eat and drink sufficient amounts to meet their needs.

Staff understood the level of support people needed and were familiar with their care and support needs. They respected people's privacy and dignity and promoted their independence. Care plans were individualised and reflected each person’s needs and preferences. People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible; the policies and systems in the service did support this practice.

People and their representatives knew how to make a complaint and their views were listened to and acted upon. The management team had a positive culture and was committed to delivering effective care for people. The provider had a number of quality assurance systems in place to monitor the quality of the service, such as surveys, audits and spot checks.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

At the last inspection the service was rated requires improvement (published 13 June 2018).

Previous recommendations:

Following the last inspection, we recommended the provider follow best practice guidelines to ensure all incidents were reported to the appropriate bodies. During this visit we noted further improvements were required.

We also made recommendations about medicines and quality assurance. This was because quality assurance and monitoring systems were not operated effectively. We found improvements were required to the way in which medicines were recorded. At this inspection we found improvements had been made and the provider had acted on our recommendations.

Why we inspected:

This was a planned inspection based on the 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.

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 there were 47 people using the service.

Not everyone using Caring Hands East London 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.

At the time of our inspection there was no registered manager in place as required by law. There was a deputy manager who was about to start the process to register. 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.

We made recommendations about medicines and quality assurance. This was because quality assurance and monitoring systems were not operated effectively. We found improvements were required to the way in which medicines were recorded. We also made another recommendation about following safeguarding reporting guidelines in all safeguarding cases. You can see what action we told the provider to take at the back of the full version of the report.

People told us they were supported by staff they trusted. They told us they felt safe. There were appropriate risk assessments in place to ensure steps were taken to minimise impact of the identified risks.

People were protected from the risks of infection because appropriate guidance was followed. The provider ensured staff were able to use equipment safely when delivering care.

People thought there was enough staff to support them. We saw effective recruitment systems in place. Staff were supported by means of a comprehensive induction and regular training and supervision. They were aware of the Mental Capacity Act 2005 and how to apply it in practice.

People were treated with dignity and respect by polite and caring staff. Their individual, religious and cultural wishes were respected. They were supported to access health care services where required and encouraged to maintain a balanced diet.

There was an effective complaints system in place which was known by people and staff. People told us they were able to raise concerns freely without any fear or reservations.

Care records were individual and reflected people’s physical, emotional and spiritual needs. These were reviewed regularly in consultation with people and their relatives.

People and their relatives thought the service was well managed. There were some systems in place to monitor the quality of care delivered.