Northolt

Updated 10 March 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

This inspection was undertaken by one inspector and 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.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. Some staff also provided care to some people living in care or nursing homes.

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

This inspection was unannounced.

Inspection activity started on 4 January 2021 and ended on 14 January. We visited the office location on 6 and 7 January 2021.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with six people who used the service and six relatives about their experience of the care provided. We spoke with the registered manager and a number of staff, including a care coordinator, a supervisor, office support staff and quality consultants working for the provider. We looked at the care records of seven people using the service, the staff files for six care workers and a variety of records relating to the management of the service.

After the inspection

We requested further evidence and continued to seek clarification from the provider to validate the evidence we found. We spoke with five care workers and three adult social care professionals who have worked with the service to get their views about the service.

Updated 10 March 2021

About the service

Northolt, also known as Lean On Me, is a domiciliary care agency. It provides personal care to mostly older people living in their own homes in the London Borough of Ealing. It also supports some adults who are living with dementia and adults who have physical disabilities. At the time of our inspection the service was providing care and support to 72 people. 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.

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

People told us they felt safe. However, the provider had not always appropriately completed risk management plans regarding the risks of the COVID-19 virus to people’s health and well-being so as to identify all t reasonably practicable measures to reduce those risks.

The provider’s systems in place to monitor the quality of the service and make improvements when required had not always been effective. Despite the provider’s checks and audits some people’s care plans had not been updated to set out the care they received, reflect people’s preferences or clearly identify how to meet some people’s communication or sensory impairment needs.

We found the provider’s systems for coordinating care visits only provided limited assurance staff were always deployed effectively to meet people’s care needs. The provider was in the process of launching an online monitoring staff monitoring system to reduce the risk of late or missed care visits.

People and relatives felt staff were caring and treated them with dignity and respect. Staff promoted people’s privacy.

There were arrangements in place to support people to take their medicines safely.

Staff felt supported in their roles and were confident they would be listened if they raised concerns. They were provided with induction, a blend of online and room-based training and supervision. Staff helped people to access healthcare services.

The provider regularly sought people’s and their relatives’ views about the quality of the care people received. The provider conducted regular checks on staff to assess the performance and how they were working with people.

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 mostly supported this practice.

We have made a recommendations about and the safe handling of people’s money.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 28 August 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made sustained and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating. It was also prompted in part due to concerns received about how the provider deployed staff to meet people’s needs effectively and a decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report. The rating for the service remains requires improvement. This is based on the findings at this inspection. You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to risk management, person-centred care, and having effective systems in place to monitor and improve the quality of the service at this inspection.

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. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.