Archived: Haringey Respite Outreach Service

Updated 29 April 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 15 December 2014 and was unannounced. The inspection continued through January when we spoke with families and reviewed further written information we had requested from the provider.

The inspection team included two inspectors, one of whom visited the provider’s office and one who visited the supported living house and spoke with families. There was also 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.

Before this inspection we reviewed all the information we held about this service, including the service inspection history. The service was registered in June 2013 and we had carried out one previous inspection on 20 and 22 December 2013. The provider was assessed to be meeting the standards we checked at that time. We reviewed notifications sent in by the provider over the past year, complaints, safeguarding alerts and information from the local authority. Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We used a number of different methods to help us understand the experiences of people using the service. We spent time observing care and how staff interacted with people in the supported living house with two people. We observed two mealtimes and we also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke to two of the four people who had been living in the supported living house. The other two people were staying with their families so we did not meet them. We spoke to the four people’s relatives to seek their views on the service.

We spoke with 8 relatives for their views on the service provided both in supported living and in the outreach service provided to people living in their family homes. We spoke with the manager, team leader and four staff members, We also spoke with the Commissioning and Safeguarding representatives from the local authority.

We looked at two people’s care records in detail. We carried out pathway tracking (where we read a person’s care plan then checked to see if staff provided the care in accordance with the care plan). We checked menus, risk assessments, six staff files, staff duty rosters, staff recruitment, training, supervision and meeting records, accident and incident records, selected policies and procedures, quality checking records and medicine administration record charts. We sent written questions to the manager, area manager and operations director following our inspection visit and received information from them afterwards which we used as part of the inspection.

Updated 29 April 2015

This unannounced inspection took place on 15 December 2014.

Haringey Respite Outreach Service provides personal care to people with a learning disability who live in their own homes. The service is provided to people living with their family and to four people living in a supported living house.

The previous inspection was in December 2013 when the service had recently opened. At that inspection we found the service was meeting all the standards that we assessed.

There was no registered manager at the time of the inspection. 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. There had been a number of changes in registered manager and area manager in the last year. The lack of continuity led to the service not being well managed.

Two people using the supported living service told us they liked the service but the other two had been removed from the service by their relatives due to concerns about the quality of care. The relatives of people using the service gave mixed feedback. Some thought it was good and said their relative was happy with the care and support provided and others said they were not satisfied with the quality of the service.

There had been an incident in the supported living house where staff had not followed proper procedures to safeguard a person from harm. The person sustained an injury which the service did not respond to or report appropriately.

Although the provider was aware of people’s needs it was not ensuring that people always had the right support they needed with eating.

The supported living service was not providing a person centred service. Some aspects of the service were not based on each person’s preferences, including food and activities.

Staff were not supported appropriately with training and supervision to ensure that they were enabled to deliver good quality care.

The provider was not monitoring the quality of the service appropriately or assessing risks regularly.

Staff had formed good relationships with people who said they liked the staff. People using the service for support to go out were satisfied with the service.

At this inspection there were breaches of regulations in relation to safeguarding people from abuse, supporting staff, support with eating and drinking, care and welfare, and quality assurance. You can see what action we told the provider to take at the back of the full version of the report.