Chinese HomeCare Specialists

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 the inspection the provider was supporting 16 people, with 9 of them receiving personal care.

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

People and their relatives were very positive about the kind, respectful and caring attitudes of the whole staff team. A relative said, “I would definitely recommend them. In my experience they are one of the best agencies and can’t ask anything more from them.”

Risks to people’s safety and health conditions were reviewed and assessed, with guidance in place to help staff support them safely. Where people were more vulnerable, enhanced monitoring was in place.

People told us they felt safe and staff had a good understanding of their health conditions. A person said, “I do feel safe yes, as I trust them when they are in my home.”

People were supported to have maximum choice and control of their life and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People and their relatives were very positive about the management team, with specific praise for their communication and level of organisation. Feedback highlighted staff went above and beyond at times with the care they provided.

People were supported by a staff team who understood people’s cultural needs and were very positive about their commitment to working for the organisation. Staff felt valued and appreciated, especially as the provider had a strong focus on their wellbeing.

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 the service was good (published 27 September 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chinese Homecare Specialists on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

After the comprehensive inspection, the provider sent in an action plan and told us what they would do to meet legal requirements in relation to notifiable incidents. We carried out this inspection to check that they had followed their plan and to confirm that they now met legal requirements. During this inspection we found that improvements had been made.

Chinese Homecare Specialists is a domiciliary care agency which provides personal care and support to people in their own homes. At the time of our visit the service was providing support to 22 people in the London Boroughs of Tower Hamlets, Lewisham, Hackney, Southwark, Newham and Islington. The majority of people who used the service and the care workers who supported them used Cantonese as their first language. All of the people using the service were funded by the local authority.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 using the service and their relatives told us they felt safe using the service and care workers understood how to protect people from abuse. Staff were confident that any concerns would be investigated and dealt with. Safeguarding training had been reviewed since the previous inspection and all staff had a good understanding of how to identify and report any concerns.

People’s risks were managed and care plans contained appropriate risk assessments which were updated regularly when people’s needs changed. The provider had a robust recruitment process and staff had the necessary checks to ensure they were suitable to work with people using the service. People had regular care workers to ensure they received consistent levels of care.

People who required support with their medicines received them safely and all staff had completed training in the safe handling and administration of medicines, which was also discussed during supervision to refresh care workers knowledge and understanding.

The provider had updated their training programme which took into account the recommendations highlighted at the last inspection. A new training programme was in place where training would be refreshed, along with it being discussed at regular supervision sessions. Interpreters and language support was provided for care workers to ensure they fully understood the training undertaken.

Care workers received an induction training programme to support them in meeting people’s needs effectively and were always introduced to people before starting work with them. They shadowed more experienced staff before they started to deliver personal care independently and received regular supervision from management. They told us they felt supported and were happy with the supervision they received and the content of the training available.

Staff understood the principles of the Mental Capacity Act 2005 (MCA). Care workers respected people’s decisions and gained people’s consent before they carried out care tasks. The provider was aware of what to do and who to contact if they had concerns that people lacked capacity to make certain decisions. The provider had carried out reviews to make sure people had consented to their care.

Care workers were aware of people’s dietary needs and food preferences and supported people if this was part of their care package. Care workers told us they communicated with the office if they had any concerns about people’s health and we saw evidence of this in the daily communication log. We saw people were supported to maintain their health and well-being through access to health and social care professionals, such as GPs, occupational therapists and social services.

People were actively involved in decisions about their care and support, in accordance with their wishes. People and their relatives told us that advocacy support and interpreting services from the provider had an incredibly positive impact on them and was an important part of the service they received. The provider made efforts to make people aware of the support that was available to them when they were reaching the end of their life.

People told us that staff were kind and compassionate, respected their privacy and dignity and promoted their independence. There was evidence that language and cultural requirements were considered when carrying out the assessments and allocating care workers to people using the service.

People were involved in planning how they were cared for and supported. An initial assessment was completed from which care plans and risk assessments were developed. Care was personalised to meet people’s individual needs and preferences and was reviewed if there were any significant changes, with health and social care professionals being updated on people’s current conditions.

People and their relatives knew how to make a complaint and felt comfortable contacting the registered manager if they had any concerns. There were surveys in place to allow people and their relatives the opportunity to feedback about the care and treatment they received. These documents were provided in both English and Chinese.

People using the service and their relatives told us that the service was well managed and they had recommended the service to other people in the community. Staff spoke highly of the support they received to carry out their responsibilities.

There were processes in place to monitor the quality of the service provided and to understand the experiences of people who used the service. This was achieved through regular communication with people and care workers, supervision and a programme of other checks and audits, including telephone monitoring and spot checks.

The registered manager was aware of their responsibilities in relation to their registration requirements and notifiable incidents, and learning had taken place since the previous inspection.

Chinese Homecare Specialists is a domiciliary care agency which provides personal care and support to people in their own homes. At the time of our visit the service was providing support to 29 people. The majority of people who used the service and the care workers who supported them used Cantonese as their first language. All of the people using the service were funded by the local authority.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and their relatives told us they felt safe using the service and care workers understood how to protect people from abuse. Staff were confident that any concerns would be investigated and dealt with. All staff had received training in safeguarding adults from abuse and had a good understanding of how to identify and report any concerns. However, training was not refreshed on a regular basis.

People’s risks were managed and care plans contained appropriate risk assessments which were updated regularly when people’s needs changed. The service had a robust recruitment process and staff had the necessary checks to ensure they were suitable to work with people using the service. People had regular care workers to ensure they received consistent levels of care.

People who required support with their medicines received them safely and all staff had completed training in the safe handling and administration of medicines. However, training was not refreshed on a regular basis.

Care workers received an induction training programme to support them in meeting people’s needs effectively and were always introduced to people before starting work with them. They shadowed more experienced staff before they started to deliver personal care independently and received regular supervision from management. They told us they felt supported and were happy with the supervision they received.

Staff understood the principles of the Mental Capacity Act 2005 (MCA). Care workers respected people’s decisions and gained people’s consent before they provided personal care. However, the service did not ensure where appropriate, that people had signed their care plans in agreement with the care to be provided.

Care workers were aware of people’s dietary needs and food preferences. Care workers told us they notified the registered manager or the assistant homecare manager if they had any concerns about people’s health and we saw evidence of this in people’s care plans. We also saw people were supported to maintain their health and well-being through access to health and social care professionals, such as GPs, occupational therapists and social services.

People and their relatives told us care workers were compassionate and caring and knew how to provide the care and support they required. Care workers understood the importance of getting to know the people they supported and showed concerns for people’s health and welfare.

People told us that staff respected their privacy and dignity and promoted their independence. There was evidence that language and cultural requirements were considered when carrying out the assessments and allocating care workers to people using the service.

People were involved in planning how they were cared for and supported. An initial assessment was completed from which care plans and risk assessments were developed. Care was personalised to meet people’s individual needs and was reviewed if there were any significant changes, with health and social care professionals being contacted to authorise changes in care received. People and their relatives were actively encouraged to express their views and were involved in making decisions about their care and whether any changes could be made to it.

People and their relatives knew how to make a complaint and were able to share their views and opinions about the service they received. There were also surveys in place to allow people and their relatives the opportunity to feedback about the care and treatment they received. These documents were provided in both English and Chinese.

The service promoted an open and honest culture. Staff felt well supported by the registered manager and assistant homecare manager and were confident they could raise any concerns or issues, knowing they would be listened to and acted on. The registered manager valued staff and appreciated the work they did.

There were processes in place to monitor the quality of the service provided and understand the experiences of people who used the service. This was achieved through regular communication with people and care workers, supervision and a programme of other checks and audits. However the registered manager failed to notify the CQC about an incident involving the police and a safeguarding concern that had been raised which is a legal requirement of the provider’s registration.

We made three recommendations in relation to staff training, consent and medicines records.

We identified one breach of the Regulations in relation to notifications and you can see what action we told the provider to take at the end of the full version of this report.

Is the service safe?

People told us they felt safe and trusted the staff. One person told us, "I trust my carer she always treats me well. I've got no complaints". Staff had received training in safeguarding people from abuse and were aware of how to raise an alert if required.

Staff received the training they needed to carry out their roles safely. We saw staff were trained to administer medication and we checked records and found people were given the correct medicines in a timely way. Care records were regularly updated to ensure people received the care they needed to keep them safe. The service worked with other healthcare professionals when they were concerned about someone's safety.

Is the service effective?

People's health and care needs were assessed in consultation with either the person themselves or relatives. People's care plans reflected their healthcare needs and the service worked in conjunction with support from outside professionals to meet people's needs. People who use the service and their relatives told us staff were always on time. People we spoke with told us they had never been let down by the service.

Is the service caring?

People were supported by staff who were kind, caring and respectful. Care workers supported people with patience and genuine affection, assisting people who required additional support in a dignified manner. One person who we spoke with told us "staff I have used have always shown great care and respect to me."

Is the service responsive?

People's care records showed that where concerns about an individual's wellbeing had been identified, staff had taken appropriate action to ensure they were provided with the support they needed. We saw that the service responded positively to comments made in annual surveys they sent out.

Is the service well led?

The service had a quality assurance system in place and we saw the manager monitored the quality of the service closely by carrying out spot checks and by contacting people who used the service and their representatives. Staff we spoke with were positive about the leadership of the service and said they felt well supported. People who use the service and their relatives were positive about the leadership of the service.

We were told that staff were polite and friendly. Comments included, "I really trust the carers' and "the carers listen to me.' A relative told us, "the carers do a good job."

We found that people who used the service had initial assessments and care plans in place. This meant Chinese HomeCare Specialists provided people with effective, safe and appropriate care and support that met their needs. We saw that requirements were agreed with people and consent was obtained before any care or support was provided. Care plans were then reviewed on a regular basis. This showed the provider had systems in place to gain and review consent from people who used the service.

The provider had taken appropriate steps to identify and prevent abuse from occurring. We saw there were sufficient numbers of suitably trained staff to support the health and welfare needs of people who used the service.

There were systems in place to deal with comments and complaints effectively.