About the service This service is a domiciliary care agency and is based in the London Borough of Barking & Dagenham. The service provides personal care to adults in their own homes. 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.
At the time of our inspection, the service provided personal care to 28 people.
People’s experience of using this service
Sufficient risk assessments were not in place to ensure people received safe care at all times. This included lack of robust risk assessment for blood thinning medicines and infection outbreaks. Medicines were not always managed safely as prescribed creams were not being recorded appropriately.
Pre-employment checks were not robust to ensure staff were suitable to support people safely.
Adequate safeguarding systems were not in place to ensure lessons were learnt following safeguarding concerns to minimise the risk of re-occurrence. We have made a recommendation in this area.
Staff had not been trained to perform their roles effectively. We found some training certificates were not genuine, which meant staff had not received training in mandatory areas to ensure people received safe and effective care.
Consent to care forms had not been completed in full. This meant people were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Quality assurance systems were not in place to identify shortfalls and take prompt action to ensure people always received safe care.
People and relatives told us staff were punctual and systems were in place to monitor time keeping. However, there were discrepancies with times staff visited people, which had not been communicated to the office by staff members.
Systems were in place to obtain feedback from people and relatives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
We carried out an inspection on 2 July 2019 and 3 July 2019. The service was rated Good (published 23 July 2019).
Why we inspected
We received concerns in relation to care being delivered to people by a local authority. As a result, we undertook a focused inspection to review the key questions of safe and well-led only and a targeted inspection on effective.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-Led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Head Office on our website at www.cqc.org.uk.
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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to risk assessments, pre-employment checks, training and good governance.
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.