Newham

Updated 9 October 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by two inspectors. An Expert by Experience made calls to people and relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because we wanted to be sure the registered manager was available when we visited the office.

Inspection activity started on 25 June 2021 and ended on 1 July 2021. We visited the office location on 25 June 2021.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with seven people who used the service and twelve relatives about their experience of the care provided. We spoke with 11 staff members, including the registered manager, four care coordinators and seven care workers. We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, call logs, two care plans and associated risk assessments. We spoke with the local authority commissioning team.

Updated 9 October 2021

About the service

Newham is a domiciliary care agency which provides personal care to people living in their own home. At the time of the inspection 51 people was using the service.

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

We found recruitment practice to be unsafe. This meant we could not be assured that staff employed were of good character and safe to work with people. Risk assessments lacked detail on how to mitigate the risks people faced. Staff deployment was not always effective, and staff were not always on time for care visits. Therefore, we could not be assured that people’s need were always met. Accidents and incidents were not always recorded, and complaints were not dealt with in line with the providers policies and procedures. The management did not identify the areas where improvements were needed to service delivery.

Systems for monitoring the quality of the service were ineffective in identifying some of the issues found during our inspection. Audits were not routinely carried out.

Staff training was not effective enough to ensure staff understood their responsibilities in reporting and acting on abuse. Staff competency to administer medicines was not comprehensively assessed.

People were not always 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 did not always support this practice. We found the principles of the Mental Capacity Act 2005 were not always followed by the service. We have made a recommendation in relation to the consent and the Mental Capacity Act.

People and relatives told us they felt safe with care staff who treated them with dignity and respect. People were involved in decisions about their care and staff were described by people and relatives as caring and kind.

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 good (published 22 May 2018)

Why we inspected

This inspection was carried out to follow up on concerns raised about the quality of care, safeguarding and the management of the service.

We have found evidence that the provider needs to make improvements.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering

what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to staff recruitment, staffing levels, staff training and supervision, complaints and management of the service.

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

We will request an action plan for 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

return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.