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Archived: Haringey Respite Outreach Service Requires improvement

This service was previously registered at a different address - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

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.

Inspection areas

Safe

Inadequate

Updated 29 April 2015

The service was not safe. Staff had not responded appropriately to a safeguarding concern which meant that people were not protected from the risk of abuse. Risks to people’s safety and wellbeing were not fully addressed.

There were enough staff on duty but staff rosters were not always planned to meet people’s needs. People were not always able to choose whether a male or female staff member supported them with personal care.

There was an effective disciplinary procedure which had been used appropriately.

The service had recently made improvements in the management of people’s medicines.

Effective

Requires improvement

Updated 29 April 2015

The service was not effective. Staff had not received appropriate training and supervision in 2014 to enable them to understand and fully meet people’s individual needs.

Arrangements for eating and drinking did not always meet the individual needs and preferences of people.

Staff supported people to have “best interests” meetings to ensure decisions they were unable to make for themselves were made in their best interests.

Since the last inspection people had not always received the medical care they needed but this had improved at the time of this inspection.

Caring

Requires improvement

Updated 29 April 2015

The service was not always caring. Staff were kind to people but people’s rights to dignity and independence were not always met.

Responsive

Requires improvement

Updated 29 April 2015

The service was not always responsive. The service was not person centred as people had not been involved in their support plans and their daily routines were not always based on their wishes.

The provider had a complaints procedure. We were not able to judge the effectiveness of the complaints process as the provider had not completed a complaint investigation at the time of this inspection.

Well-led

Requires improvement

Updated 29 April 2015

The service was not well-led. The provider had not monitored the quality of the service effectively, assessed risks or asked people for their views on the service regularly. A lack of consistent leadership had a negative impact on the quality of the service.