17 February 2022
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.
The inspection was carried out by one inspector and an Expert by Experience. 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 homes.
The service had a registered manager who was a director of the provider organisation. 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.
Notice of inspection
We announced the inspection 24 hours prior to the inspection. This was because we wanted to make sure someone would be available to support us with the inspection.
What we did before the inspection
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 reviewed the information we already held about the service. This included previous inspection reports and notifications. A notification is information about important events, which the provider is required to tell us about by law. We used all of this information to plan our inspection.
During the inspection
We spoke with the registered manager. We reviewed documents and records that related to people’s care and the management of the service. We reviewed four care plans, which included risk assessments and four staff files, which included supervision and training records. We looked at other documents such as daily notes and quality assurance records.
After the inspection
We continued to seek clarification from the provider to validate evidence we found such as policies. We spoke with two people, four relatives and two staff.
17 February 2022
About the service
This service is a domiciliary care agency and is based in the London Borough of Havering. 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 nine people, primarily older people.
People’s experience of using this service
Risks were identified and were assessed to ensure people received safe care. Medicines were being managed safely. Pre-employment checks had been carried out to ensure staff were suitable to support people. People and relatives told us people felt safe when receiving support from staff and staff were aware of how to safeguard people from abuse. There were appropriate numbers of staff to support people when required. Systems were in place to prevent and minimise the spread of infections when supporting people. Systems were in place to learn from lessons following accident and incidents.
Staff had completed essential training to perform their roles effectively and felt supported in their roles. 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.
People received care from staff who were caring and had a good relationship with them. Staff respected people’s privacy and dignity. People were encouraged to be independent and to carry out tasks without support.
People received person-centred care. Care plans had been reviewed regularly to ensure they were accurate. Systems were in place to manage complaints and people’s communication needs were met.
Quality assurance systems were in place to identify shortfalls to ensure there was a culture of continuous improvement. Feedback was sought from people and staff and this was used to make improvements to the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The previous rating for this service was requires improvement (published 27 May 2020) and there were multiple breaches of regulation. We issued a warning notice for a breach of Regulation 17 (Good Governance). There were also requirement notices issued for Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment) and Regulation 19 (Fit and proper persons) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We carried out a targeted inspection on 22 September 2020 (published 15 October 2020) to check if the service was compliant with the warning notice we served for Regulation 17 (Good Governance). We found the service was compliant with the warning notice.
Why we inspected
This was a planned inspection based on the rating of the last inspection.
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.