We undertook an announced inspection of Carpenders Care Limited on 18 December 2018. Carpenders Care Limited is a domiciliary care agency registered to provide personal care to people in their own homes. The agency provides personal care support to elderly people in North West London. At the time of the inspection the service provided care for 14 people. CQC only inspect the service received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.There was a registered manager in post. 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.
During our last inspection in June 2016 we rated the service as overall Good.
Some people who used the service were unable to verbally communicate with us due to their mental capacity and we therefore spoke with their relatives. People who used the service and relatives told us they were satisfied with the care and services provided and raised no concerns. People told us they were treated with respect and dignity by care support staff and said they felt safe when care support staff were in their homes. Relatives spoke positively about care support staff and said that the service was well-managed.
Systems were in place to help ensure people were protected from the risk of abuse. Staff records indicated that staff had received safeguarding training and staff confirmed this. Staff were aware of the process for identifying concerns and said that they would report their concerns to management.
Risks to people had been assessed, updated and regularly reviewed to ensure people were safe and risks to people in relation to treatment or care were minimised.
Appropriate arrangements were in place in relation to medicines management. The service had a system in place for auditing medicine administration records (MARs).
The registered manager explained that the service had experienced difficulties employing care support staff and that a number of staff had left the service. The registered manager confirmed that at present the service was able to safely meet people’s needs but said that she had decided not to take on further clients until she had employed more care support staff and was in the process of recruiting staff at the time of this inspection.
People told us they experienced consistency in the care they received. Relatives we spoke with confirmed this and said that people received care from the same care support staff. People and relatives also told us that there were no issues with care support staff's punctuality and attendance. During the inspection, we noted that the service did not have appropriate systems in place to audit care support staff punctuality and attendance. We discussed this with the registered manager and she advised that she would implement a system to monitor this.
People were cared for by care support staff that were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Records showed that care support staff received appropriate training. The registered manager supervised care support staff though a combination of supervision sessions and spot checks. However, it was not evident that these took place consistently and at regular intervals over a period of a year. We raised this with the registered manager and she explained that she would ensure these were carried out consistently.
Care support staff had a good understanding of and were aware of the importance of treating people with respect and dignity and maintaining people’s independence. They also understood what privacy and dignity meant in relation to supporting people with personal care. Feedback from people and relatives indicated that positive relationships had developed between people and care support staff.
Care support plans were individualised and included detailed information about people's personal care, what tasks needed to be carried out, people's needs and how these needs were to be met. Care support plans focused on ensuring people's individual needs and wishes were respected and included information about people’s preferences.
The service had a complaints procedure in place and people and relatives we spoke with told us they would not hesitate to raise concerns with the registered manager.
There were systems in place to monitor and improve the quality of the service. We found the service had a system in place to obtain feedback from people about the quality of the service they received through satisfaction surveys and review meetings. The service carried out audits of the quality of the service to monitor the progress of the service. Audits had been carried out in relation to care documentation, staff files and medicines. The aim of this audit was to look at the overall running of the service.