Archived: Barnet Office

Updated 27 October 2021

The inspection

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.

Inspection team

The inspection was carried out by two inspectors and two Experts 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. They made telephone calls to people using the service and their relatives.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was to ensure that the registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service and sought feedback from the local authority to plan our 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 took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with three members of staff including the registered manager, care co-ordinator and field supervisor.

We reviewed a range of records which included six people’s care records, medication records, staff induction and supervision records and management information. We also looked at five staff recruitment files.

After the inspection

We spoke with six people who used the service and five relatives by telephone about their experience of the service. We also spoke to a further six care staff. We continued to seek clarification from the registered manager and spoke with the operations manager for more information. We requested further information to be sent for review including training data, quality assurance records, meeting minutes, policies and procedures. We continued to communicate with the local authority to share information.

Updated 27 October 2021

About the service

Barnet Office is a home care agency which provides personal care to people living in their own homes in the community. At the time of our inspection this agency was providing a home care service to 20 people living in the London Borough of Barnet.

People’s experience of using this service and what we found

The service did not always assess risks to people’s safety. Where risk assessments had been carried out, these lacked instructions for staff on how to keep people safe. People experienced several missed visits due to poor staffing arrangements. The service did not ensure people’s medicines were always managed appropriately and we found numerous errors with documentation.

We recommended the provider to improve their recruitment practices and ensure all checks are performed as per requirements.

We found a lack of management oversight. Systems were not robust enough to monitor the quality of service delivered to people.

People’s capacity was not clearly documented and assessments did not take place. This meant people were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; policies were in place but procedures in the service did not support this practice.

People and relatives were not always satisfied with how their complaints were handled. While they were able to express concerns, some relatives felt these were not dealt with satisfactorily by the service. We recommended that the provider reviews its procedures for managing complaints.

While people’s needs were assessed, these were not always documented accurately. Care plans lacked details on how people's health and medical conditions impacted on the way they received care.

We have made recommendations around ensuring care plans are person centred and reflective of people's assessed care needs.

Staff followed infection control and prevention measures and people told us they felt safe. One person told us, “The carers do wear all their gear (Personal Protective Equipment) and the disposal of it afterwards is good.”

People and relatives told us staff were caring and preserved people’s dignity. People were able to express their views and staff maintained good working relationships with them.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service registered with us on 9 February 2021 and this was their first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about some specific areas including management oversight, medicines and risk assessments. A decision was made for us to inspect and examine those risks.

Enforcement

We have identified breaches in relation to assessing risks, medicines management, staffing and good governance at this inspection. 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.

Please see the action we have told the provider to take at the end of this report.

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.