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Inspection Summary


Overall summary & rating

Good

Updated 19 July 2018

This announced inspection took place on 24 May 2018.

Home Instead Enfield is a domiciliary care agency based in Enfield, North London. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, many of whom are living with dementia. Eleven people were receiving personal care at the time of inspection.

This was the first inspection since the service registered in May 2017.

There was a registered manager in place. 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.

Relatives spoke positively of the dedication and passion of the management team to ensure their loved ones lived as full a life as possible. The registered provider had developed strong links with the local community. They worked alongside other social care organisations to promote social care causes and make improvements. The registered manager and management team carried out regular checks and audits to ensure that the people were receiving high quality care.

People and relatives praised the caring and compassionate nature of the care staff. The provider supported staff to understand the emotional and social needs of people living with dementia and was actively involved in achieving positive local outcomes to improve the quality of life for people living with dementia.

People and relatives told us they felt safe. Procedures and policies relating to safeguarding people from harm were in place and accessible to staff. All staff had completed training in safeguarding adults and demonstrated an understanding of the different types of abuse to look out for and how to raise safeguarding concerns.

Detailed risk assessments were in place for people using the service and were reviewed and updated regularly. Risk assessments explained the signs to look for when presented with a possible risk and the least restrictive ways of mitigating the risk based on the individual needs of the person.

Medicines were managed safely. Staff had completed medication training and the service had a clear medication policy in place which was accessible to staff. There were regular medicines audits in place.

The provider employed sufficient skilled and experienced staff to meet people's needs. We saw evidence of a comprehensive staff induction and on-going training programme. Staff were recruited with necessary pre-employment checks carried out. Staff received regular supervisions and annual appraisals.

Care plans were person centred and reflected what was important to the person. Care needs were regularly reviewed and updated to meet the changing needs of people who used the service.

People and their relatives told us they received kind and compassionate care and were treated with respect.

All staff had received training on the Mental Capacity Act (2005) and staff understood what to do if they had concerns around people's mental capacity.

People were supported to maintain good health and had access to healthcare services. People were supported to be independent and access the community, where possible.

There was a complaints procedure in place and people and relatives confirmed that they knew how to complain. The provider actively sought feedback from people and relatives.

Inspection areas

Safe

Good

Updated 19 July 2018

The service was safe. There were sufficient staff to ensure that people's needs were met. There was a robust recruitment procedure in place.

Staff were aware of the different types of abuse and what steps they would take if they had safeguarding concerns.

People were supported to have their medicines safely. Medicine Administration Records (MAR) were audited monthly.

Risks to people who used the service were identified and managed effectively.

Effective

Good

Updated 19 July 2018

The service was effective. Staff had access to regular training, supervisions and appraisals which supported them to carry out their role.

People were given the assistance they required to access healthcare services and maintain good health.

People made decisions and choices about their care. Staff understood the Mental Capacity Act 2005 and how the legislation impacted on their role and the people they provided care to.

Caring

Good

Updated 19 July 2018

The service was caring. People had good relationships with their core group of carers.

People's views were sought and they were supported to make decisions about how their care and support was delivered.

People were encouraged and supported to maintain their independence.

Responsive

Good

Updated 19 July 2018

The service was responsive. Care plans were person centred.

People's needs and wishes from the service were assessed and support was planned in line with their needs.

There was a complaints procedure in place and relatives told us they knew how to complain if needed.

Well-led

Good

Updated 19 July 2018

The service was well led. Staff spoke very positively of the supportive nature of the management team. Relatives told us the service was well led and the management team was always accessible.

The registered provider maintained strong links with the local community and supported and engaged in projects and initiatives to improve the provision of social care in the locality.

The service regularly requested feedback from people who used the service and improvements were made because of people's feedback.

The quality of the service was monitored.