16 Westmoreland Road Also known as Quality of Life Homecare Limited

Unit 2 Watling Gate is a domiciliary care agency. It provides personal care and support to people living in their own houses and flats in the community. At the time of our inspection the service was supporting 120 people. A number of people using the service were receiving short term ‘reablement’ support to enable them to regain skills following their return home after hospital treatment. At the time of inspection all people using the service received personal care used the service received personal care. This changed on a regular basis as people receiving reablement support regained independence. 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

The care and support provided to people was person centred. People’s care plans and risk assessments included information about their preferred care and support needs and preferences. Guidance for staff on ensuring that people were supported safely and in accordance with their wishes was included in people’s care records.

Staff had received training about safeguarding and knew how to respond to and report any allegation or suspicion of harm or abuse. They understood the importance of reporting concerns immediately.

The service’s recruitment procedures were designed to ensure that staff were suitable for the work they would be undertaking. New staff members were not assigned work until satisfactory references and criminal records disclosures had been received.

New staff received an induction to the service before starting work. All staff received regular training to ensure that they were able to meet the needs of the people they supported. Staff also took part in regular supervision sessions to support them in carrying out their roles.

People and their family were involved in decisions about their care. People had been involved in agreeing their care plans and participated in reviews of the care and support provided to them. People and family members said that staff asked people for their consent to carry out care and support tasks.

Information about people’s religious, cultural and communication needs was included in their care plans. People had been matched with staff who were knowledgeable about their needs.

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 were regularly asked about their views of the care and support that they received. Spot checks to look at the quality of care and support had taken place in people’s homes.

Processes were in place to manage and respond to complaints and concerns. People and family members were aware of the service’s complaints procedure and knew how to make a complaint if they needed to.

The provider undertook a range of audits to check on the quality of care provided. Actions had been taken to address any concerns.

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 this service was Good (published 4 May 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to inspect as part of our re-inspection programme. If we receive any concerning information we may inspect sooner.

We had undertaken a focused inspection of Unit 2 Watling Gate on 2 and 6 September 2016 at which a breach of legal requirements was found. This was because suitable reference and criminal records checks were not in place for all staff members working at the service. Following this inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to this breach.

Our inspection of Unit 2 Watling Gate took place on 21 and 24 February 2017 and was announced. 48 hours’ notice of the inspection was given because we wanted to be sure that a manager was available when we visited.

We had undertaken a focused inspection of Unit 2 Watling Gate on 2 and 6 September 2016 at which a breach of legal requirements was found. This was because suitable reference and criminal records checks were not in place for all staff members working at the service. Following this inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to this breach.

During our inspection of 21 and 24 February 2017 we found that the provider had followed their plan and actions to address the breach had been taken.

Unit 2 Watling Gate provides domiciliary care services to people who live in the London Borough of Harrow. At the time of this inspection the service was working with 60 people, some of whom were receiving short term reablement support following a stay in hospital.

The service has a registered manager. 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.

People told us that they felt safe when receiving care. Staff members understood how to safeguard the people whom they supported. There were sufficient numbers of staff employed to ensure that people’s needs were met and that there was continuity of care. The provider had carried out checks to ensure that staff members were of good character and suitable for the work that they were engaged in.

Arrangements were in place to ensure that risks associated with the provision of care and support were assessed and managed. Risk assessments were linked to guidance for staff on how to manage risk and had been regularly reviewed and updated where there was any change.

Staff received regular training that covered a wide range of topics which met national training standards for staff working in health and social care services. They were able to describe the training that they had received and tell us about how it helped them to support the people with whom they worked.

Arrangements were in place to ensure that staff were provided with regular supervision by a manager. Supervisions were supported by regular unannounced “spot checks” of care which took place in people’s homes.

Care plans were in place detailing how people wished to be supported, and people were involved in making decisions about their care. People and family members told us that they thought that staff who worked with them were professional, caring and respectful. Staff spoke positively about the work that they did and the people whom they supported.

People knew how to contact the office and were confident that the provider would deal with complaints appropriately and quickly. We saw that people’s feedback about the service showed high levels of satisfaction with the care and support that they received.

There were effective processes in place to monitor the care and welfare of people and improve the quality of the service. The provider was introducing an electronic quality assurance system to improve the effectiveness of such monitoring.

We inspected Unit 2 Watling Gate on 2 September 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service and the registered manager is often out undertaking duties associated with the service. We returned to the service on 6 September to obtain further information. We undertook this focused inspection as a response to concerns that we had received about the service in relation to staff recruitment and support, and the monitoring of care and safeguarding procedures.

During our previous comprehensive inspection of the Unit 2 Watling Gate in March 2015 we rated the service as good. We made one recommendation in relation to the introduction of formal medicines administration records.

We undertook this focused inspection in order to follow up concerns that we had received about the service in relation to staff recruitment and support, and the monitoring of care and safeguarding procedures.

Unit 2 Watling Gate provides domiciliary care services to people who live in the London Borough of Harrow. At the time of this inspection the service was working with 30 people, the majority of whom were receiving short term reablement support.

A registered manager was in place at the service. 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.

Staff members were recruited in a way that ensured that they were suitable for the work they were undertaking in most cases. However, we were not satisfied that recruitment had always been undertaken safely. We were unable to see that references had been obtained for two staff members. We also found that the provider had not always sought criminal records and disclosure checks prior to staff being employed by the service. The records for two staff members related to previous employment.

We found that records of the on-going support that staff members received in their role were limited. Some staff members had not received recorded supervision and appraisal to ensure that they were competent in their roles.

The provider did not have formal processes in place to monitor whether or not care workers were on time and stayed the allocated time for their visits. Although some monitoring took place, there were limited records of this, particularly in relation to people who might be unable to say whether or not care visits took place appropriately.

Records of safeguarding concerns were maintained by the provider. These had been recorded appropriately and reported to the local authority safeguarding team in a timely manner.

Appropriate records in relation to medicines administration were in place.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.