We carried out a review of the data available to us about Churchill Health Care (Harrow) 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 Churchill Health Care (Harrow), you can give feedback on this service.
Churchill Health Care (Harrow) is a domiciliary care agency. The agency provides personal care to people living in their own homes in the community in the London boroughs of Harrow and Ealing. There were approximately 82 people using the service at the time of our inspection, most of whom were living with conditions associated with ageing, including dementia. 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
Care staff were safely recruited, and essential pre-employment checks had been carried out. The provider had acted to address concerns we found at our previous inspection about staff punctuality when attending care visits. An electronic call monitoring and care recording system had been introduced and this had led to improvements in people receiving care in a timely manner.
People were protected from potential risks. Risks to people’s health and wellbeing had been assessed. Risk assessments contained guidance for care staff on minimising risks to people.
There were suitable arrangements to ensure that people received their medicines as prescribed. Care staff had received medicines administration training and knew how to administer medicines safely.
People’s care needs had been assessed. They and their representatives, where appropriate, had been engaged in the development of care plans and risk assessments. Regular reviews of care took place. The provider’s electronic care recording system ensured staff were immediately notified of any changes in people’s needs.
People were protected from the risk of abuse or harm. Care staff had received training on how to safeguard people. They were aware of their responsibilities if they suspected that people were at risk of abuse or harm.
People who used the service had been treated with dignity and respect. They and their relatives told us they felt safe when supported by care staff.
People were aware of the provider’s complaints' procedure and knew how to complain or raise concerns. The service’s records indicated that complaints had been responded to.
The provider had made improvements to their quality monitoring system. Regular audits and reviews of care and safety had taken place.
Staff had worked closely with other health and social care professionals to ensure people’s needs were met.
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 the service was Requires Improvement (published on 30 July 2021) and there were 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 the provider was no longer in breach of regulations.
At our last inspection we recommended that the provider reviewed its communication with staff to ensure they received up to date information about people’s needs. At this inspection we found the provider had acted on this recommendation and had made improvements.
Why we inspected
We carried out an announced focused inspection of this service on 8 June 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve staffing and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Churchill Health Care (Harrow) on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
People’s experience of using this service:
Care staff were safely recruited, and essential pre-employment checks had been carried out. There had been significant staff sickness due to COVID-19 and this resulted in a shortage of care staff. Some care staff did not always turn up on times that were agreed with people and their representatives. There were also some occasions when some care staff did not turn up. This meant that people did not always receive the agreed care. We have made a requirement in respect of this.
People’s care needs had been assessed. They and their representatives had been consulted regarding the care provided and plans of care had been prepared. Regular reviews of care took place. However, some people did not always receive person-centred care as care staff were not always fully informed. We have made a recommendation in respect of this.
People had been protected from abuse. Care staff had received training on how to safeguard people and were aware of the procedure to follow if they suspected that people were subject to, or at risk of abuse.
People who used the service had been treated with dignity and respect. They and their relatives told us that they felt safe when attended to by care staff.
People were protected from potential risks. Risks to people’s health and wellbeing had been assessed. Risk assessments contained guidance for care staff on minimising risks to people.
There were suitable arrangements to ensure that people received their medicines as prescribed. Care staff had received medicines administration training and knew how to administer medicines safely.
The service had arrangements for responding to complaints. People were aware of the complaints' procedure. The records indicated that complaints had been responded to.
Some aspects of the service were not well managed. Although there was a quality monitoring system in place, it was not sufficiently effective in ensuring that people received good quality care. We have made a requirement in respect of this. The service worked closely with health and social care professionals to meet the needs of people.
Rating at last inspection:
The last rating for the service was Good (published on 12 July 2019).
Why we inspected:
We undertook this focused inspection as we had concerns regarding the service, and we wanted to check that people were well cared for. The inspection was prompted in part due to concerns we received recently about the reliability of the service and the safety of people who used the service. A decision was made for us to inspect and examine those risks. This report only covers our findings in relation to the key questions of Safe, Responsive and Well-led. The ratings from the previous comprehensive inspection for the key questions not looked at on this occasion was used in calculating the overall rating at this inspection. The overall rating for the service is now requires improvement.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Churchill Health Care (Harrow) on our website at www.cqc.org.uk.
You can see what action we have asked the provider to take at the end of this full report.
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.
Seva Care Home Services is a domiciliary care agency. The provider for the agency is Churchill Health Care Ltd also known as Seva Care. The agency provides personal care to people living in their own homes in the community. There were approximately 65 people using the service at the time of our inspection. The provision of personal care is regulated by the Care Quality Commission.
People’s experience of using this service:
People and their relatives were satisfied with the services provided. They stated that staff were competent and felt safe when cared for by staff.
Risks to people’s health and wellbeing had been assessed and this included risk of falling and pressure sores. There was guidance for staff on how to minimise risks to people.
The service had a safeguarding policy and procedure. Staff had received training on how to safeguard people and were aware of the procedure to follow if they suspected that people were subject to, or at risk of abuse.
Staff had received medicines administration training and knew how to administer medicines safely. Regular audits of medicines administration records (MARs) were carried out to ensure that errors were identified and promptly responded to.
Staff were carefully recruited, and essential pre-employment checks had been carried out. There were enough staff to attend to people’s needs.
The healthcare needs of people had been assessed and staff worked closely with healthcare professionals to meet the needs of people.
Staff encouraged people to have a healthy diet where this was part of their contracted responsibilities. They were aware that if there were significant fluctuations in people’s weight, they should alert relatives and professionals involved.
Staff had received appropriate training and they had the knowledge and skills to support people. The registered manager and senior staff provided staff with regular supervision, spot checks and a yearly appraisal of their performance.
Staff understood their obligations regarding the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
Staff were caring and treated people with dignity and respect. They had received training on ensuring equality and valuing diversity and respecting the human rights of people. Staff formed positive relationships with people and their preferences had been responded to.
People’s care needs had been fully assessed and staff were knowledgeable regarding people’s needs. The service provided people with person-centred care and support that met their individual needs and choices.
Complaints were listened to and used as opportunities to improve the service. Complaints recorded had been promptly responded to.
The service was well managed. Morale among staff was good. Management monitored the quality of the services provided via regular audits and checks. The results of satisfaction surveys indicated that people and their representatives were mostly satisfied with the care and services provided. Suggestions made for improving the service had been responded to.
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 17 December 2016).
Why we inspected:
This was a scheduled planned comprehensive inspection.
Follow up:
We will continue to monitor the service through the information we receive.
The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.
People who used the service and their representatives informed us that they were satisfied with the care and services provided for people. They informed us that people had been treated with respect and dignity. They stated that people were safe when cared for by the service. There was a safeguarding adults policy and suitable arrangements for safeguarding people from abuse.
The service had suitable arrangements for the administration of medicines. Medicine Administration charts were regularly checked by the registered manager to ensure that people received their medicines as prescribed. The service had an infection control policy and people and their representatives informed us that care workers observed hygienic practices.
The service had an infection control policy together with the Department of Health’s code of practice on the prevention and control of infection. Care workers were aware of good hygiene practices.
Care workers had been carefully recruited. The necessary checks had been undertaken prior to them starting work. New care workers had been provided with a comprehensive induction and training programme to enable them to care effectively for people. They had the necessary support and supervision from senior staff and the registered manager. Teamwork and communication within the service was good. There were sufficient care workers to meet people's needs.
Care workers were pleasant in their approach and knowledgeable regarding the individual choices and preferences of people. People’s care needs and potential risks to them had been carefully assessed and guidance provided to care workers on how to care for people. The registered manager and senior care workers prepared appropriate and up to date care plans which involved people and their representatives. The choices and preferences of people had been responded to.
The service regularly sought people’s feedback on how well the service operated. There were arrangements for encouraging people and their representatives to express their views and make suggestions. Regular and systematic reviews of care had been carried out to obtain feedback from them and ensure that people received appropriate care.
One complaint which had been recorded was promptly responded to. Social care professionals provided positive feedback regarding the management of the service. They indicated that the service was well run and the agency worked well with them.
Audits and checks of the service had been carried out by the registered manager and a director of the company. These included spot checks on care workers, care records, complaints and staff records. The service produced a monthly newsletter so that both staff and people who used the service were informed of changes and development which may affect them. People and their representatives had also been invited to the service’s outings and social gatherings.
People and their representatives expressed confidence in the management of the service. They stated that care workers communicated well with them and they found the service to be well managed. Care workers were aware of the values and aims of the service and this included treating people with respect and dignity and providing a high quality care.
All the people we spoke with told us that they were able to make choices about the care they received. They said that they had regular care workers who knew how they wished to be assisted. The relative of a person who used the service told us, 'The care workers give (the person) choices. Most of them speak to (the person) the way (the person) likes.'
The people we spoke with confirmed that they were able to make their views known and that any concerns that they may have were addressed. One person told us that the manager called them from time to time to ask their views, and said, 'I know that I can always call the office if I have any concerns.'
All the care workers we spoke with told us that they received appropriate support from their managers. They said that they had regular schedules which allowed them time to travel between visits. They were given good information on new clients so that they knew what support was needed before they visited them.
People who use the service, their representatives and staff were asked for their views about their care and treatment. A field officer for the agency visited each person using the service regularly to review their care needs and discuss any concerns they may have.
Care plans included information on how each person communicated, for example by making sounds and using facial expressions and gestures. The provider may find it useful to note that care plans were not provided in a format that people with a learning disability could understand and show their agreement.
Staff who we spoke with said that they received the training and support that they needed to meet the needs of the people using the service. We saw evidence of induction training that followed recognised induction training standards.