Archived: The Roof Support Services UK Ltd

The Roof Support Services UK Ltd is a domiciliary care agency. It provides care and support to people in their own homes in the London Borough of Brent. The provider supports people living with mental health needs, dementia or who have physical disabilities. At the time of our inspection the service was providing care and support to 77 people although only 10 people 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 and relatives thought the service was good and said they were safe. There were procedures in place to protect people from harm and abuse. There were arrangements for preventing and controlling infection. Staff supported people with their medicines safely.

There were enough staff to meet people’s needs. Staff received supervision and training and felt supported by their managers. The provider had systems to ensure they only employed fit and proper staff to provide care and support.

The provider developed care plans with people and their relatives, which set out their likes, care preferences and communication needs. People and their relatives knew how to raise issues or complaints and said the provider was approachable and responsive.

There were systems in place to monitor the quality of the service and make improvements when required. People, relatives and staff were asked to give feedback about the service. They felt the service was managed well. The provider worked in partnership with other

professionals and services to meet people's needs.

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 (26 May 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. At our last inspection we recommended that the provider consider current guidance on reviewing and updating people's care and risk management plans so as to assesses and support people to manage risks to their safety and well-being. At this inspection we found the provider had made improvements.

Why we inspected

We carried out an announced comprehensive inspection of this service on 22 April 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve managing medicines, person-centred care and having effective systems in place to monitor and improve the quality of the service. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, responsive and well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Roof Support Services UK Ltd 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.

The Roof Support Services UK Ltd is a domiciliary care agency. It provides care and support to people in their own homes in the London Borough of Brent. The provider supports people living with mental health needs, dementia or who have physical disabilities. At the time of our inspection the service was providing care and support to 80 people although only 12 people 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 and relatives spoke positively about their experience of the service. They told us they found the support staff and managers to be caring, friendly and treated people well. One relative said, “They’re a breath of fresh of air, I would recommend them to anyone.”

However, systems in place to monitor the quality of the service and make improvements when required had not always been effective. Medicines support was not always managed safely. Some people’s care plans had not been updated to provide personalised information about their preferences for how they liked to be supported or how to meet their communication needs.

People told us they felt safe. People and relatives felt staff were caring and treated them with dignity and respect. People said staff respected their privacy and promoted their independence.

There were arrangements in place for preventing and controlling infection.

Staff received supervision and training. They told us they felt supported by managers who were always available to them. There were procedures in place to ensure the provider only employed fit and proper people to provide care and support.

People were supported to maintain their health and access healthcare services. Staff worked with other agencies to provide people with joined up care.

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.

We have made recommendations about people’s risk management and care plans.

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 12 November 2019) and there were multiple breaches of regulation. 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 and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

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 managing medicines, person-centred care and having effective systems in place to monitor and improve the quality of the service. You can see the CQC’s regulatory response to these concerns at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.

The Roof Support Services UK Ltd is a domiciliary care agency. It provides care and support to people in their own homes in the London Boroughs of Brent and Harrow. The provider supports people living with mental health needs, dementia or who have physical disabilities. At the time of our inspection the service was providing care and support to 34 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. The provider had one location from which they managed this service.

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

People told us that they felt safe. However, the provider had not always assessed the risks to people's health and well-being or done all that was reasonably practicable to lessen those risks.

People received support with their medicines, but the provider did not always ensure this was managed safely. The provider had not assessed staff as competent to give the medicines support being asked of them, medicines support records were not sufficiently detailed, and there was not always information for staff on when to help people take medicines they only needed occasionally.

Staff received training and supervision, but staff did not receive training on how to support people with their specific needs, such as epilepsy or dementia. The provider did not always maintain up to date employment and induction records for all care staff.

People's care and risk management plans set out the care tasks they required help with, but these plans did not provide personalised information about people and their preferences for how they liked to be supported. The provider did not always record how staff were to meet people’s communication needs.

There were systems in place to monitor the quality of the service and recognise when improvements were required. These were not sufficiently robust to have identified the issues we found in relation to the management of risks to individuals' health and wellbeing, medicines management, and care planning.

We received mixed feedback from people and their relatives about using the service. Some people said staff were caring and treated them with respect, other people felt this was not always the case.

Staff sometimes provided extra support and assistance to people when this was not part of people's contracted care arrangements.

Staff received regular supervision. Staff found the managers approachable and told us they felt supported.

Adult social care professionals told us managers were responsive to and worked in partnerships with statutory agencies to meet people’s needs.

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

Why we inspected

This inspection was a planned inspection based on the previous rating.

Rating at last inspection

The last rating for this service was good (published 3 Feb 2017).

Enforcement

We have identified five breaches of regulations at this inspection. These were in relation to managing medicines and risks to people’s safety, person-centred care, staff training and recruitment, and having effective systems in place to monitor and improve the quality of the service.

We have served requirement notices for the breaches of regulations in relation to managing medicines and risks to people’s safety, person-centred care, and staff training and recruitment. We have served a warning notice for the breach of regulation in relation to having effective systems in place to monitor and improve the quality of the service.

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. We may inspect sooner if we receive any concerning information about the quality and safety of the service.

The Roof Support Services UK Ltd is a domiciliary care service providing personal care and support to people in their home. At the time of this inspection, the service was providing support to three people.

The service had 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.

The provider had systems to keep people safe, people felt safe with the service they received and staff knew how to protect them from potential abuse.

There were enough care workers recruited to care for and support people and the provider carried out checks before care workers started to work with people.

Care workers had the training and support they needed to care for and support people using the service.

Care workers understood and respected people's decisions and choices.

People were supported to eat and drink sufficient amounts and were assisted by staff to access healthcare services when needed.

Care staff understood people’s care and support needs and people told us their care was provided in kind and sympathetic way.

People were involved in planning their care which was delivered by staff in ways that respected their privacy and dignity.

People were involved in assessments of their care and support needs and the provider ensured they received care and support in ways they preferred.

People could be confident their concerns would be listened to and acted on.

The service had a qualified and experienced manager who was committed to delivering high quality, person centred care and support to people using the service.

The provider had systems in place to monitor quality in the service and make improvements.