We carried out a review of the data available to us about Care Central (Tottenham) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Care Central (Tottenham), you can give feedback on this service.
People’s experience of using this service
People using the service had risk assessments carried out to protect them from avoidable harm or abuse. Staff were knowledgeable about safeguarding and whistleblowing procedures. People’s medicines were managed safely.
We have made a recommendation about personal protective equipment.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff were supported to carry out their role. People’s care needs were assessed before they began to use the service. Staff supported people with their nutritional and healthcare needs when required.
We have made a recommendation about the recording in people's care plans of specific health conditions.
People and relatives thought staff were caring. Staff described how they got to know people’s care needs and developed positive relationships. The service involved people and relatives in decisions about the care. Staff promoted people’s choices and knew how to provide an equitable service. People’s privacy, dignity and independence were promoted.
Care plans were personalised and contained people’s preferences. The provider understood how to meet people’s communication needs. Where required, staff supported people to participate in activities of their choosing. The provider dealt with complaints appropriately. The service had a policy and systems in place to provide people with end of life care if needed.
The provider had systems in place to carry out regular quality checks and to capture feedback from people about the quality of the service in order to identify areas for improvement. Staff had regular meetings to be updated on service developments. The service worked in partnership with other agencies to provide good outcomes for people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 18 July 2018) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Care Central (Tottenham) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Not everyone using Care Central (Tottenham) 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 the inspection it was providing a service to 92 people.
There was a registered manager at the service at the time of our inspection. 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 and associated Regulations about how the service is run.
We found support plans lacked detail regarding the specific nature of the support people needed and people’s preferences were not always clearly captured. Risks people faced had been identified, but the measures in place to mitigate them were not clear. Support plans were not always reviewed when people’s needs changed.
There was enough staff to meet people’s needs. Medicines were managed in a safe manner. There were sufficient numbers of suitable staff employed by the service. Staff had been recruited safely with appropriate checks on their backgrounds completed. People were protected by the prevention and control of infection. People and their relatives told us they felt the service was safe, staff were kind and the care received was good. We found staff had a good understanding of their responsibility with regards to safeguarding adults. Staff undertook training and received regular supervision to help support them to provide effective care.
Staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA). MCA is law protecting people who are unable to make decisions for themselves. People who had capacity to consent to their care had indicated their consent by signing consent forms. However, where people lacked capacity to consent to their care the provider had not followed the principles of the Mental Capacity Act (MCA) 2005. We have made a recommendation about following the principles of the MCA.
People and their relatives felt supported with food and drinks. However, care records did not always show people’s dietary needs were assessed, such as their food preferences, likes and dislikes and how they should be assisted with their meals. We have made a recommendation about recording people’s dietary needs.
People’s support plans were task focussed and lacked detailed guidance for staff to follow when supporting people. They did not always describe peoples likes and dislikes. However, feedback from people and relatives confirmed they felt they were receiving personalised care that met their needs. We have made a recommendation about recording support that is person-centred, detailed and reflects people’s preferences.
People’s cultural and religious needs were respected when planning and delivering care. Discussions with staff members showed that they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service.
The service had an end of life policy for people who used the service. The service did not explore end of life wishes during the initial needs assessment and care planning. At the time of the inspection the service was not providing support to people at end of life.
The provider had a system in place to log and respond to complaints. People and their relatives were aware of how to make a complaint. However, complaints were not being recorded in the provider’s complaint’s log.
The registered manager was viewed positively by the people who used the service, relatives and staff. People and their relatives viewed staff positively and staff were viewed as caring. However, quality assurance processes were not sufficient to adequately pick up and address shortfalls in service provision.
We found the registered provider was not meeting legal requirements and was in breach of two Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to safe care and treatment, and good governance.
You can see what action we told the provider to take at the back of the full version of the report.