Soma Healthcare (East London)

Soma Healthcare (East London) is a domiciliary care service that provides care and support to people living in their own houses or flats in the community. At the time of our inspection, 4 people were using the service. 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

The service had safeguarding procedures in place and staff had a clear understanding of these procedures. Appropriate recruitment checks had taken place before staff started work and there were enough staff available to meet people’s care and support needs. Risks to people had been assessed to ensure their needs were safely met. The service had procedures in place to reduce the risk of infections. People’s medicines were managed safely.

People’s care and support needs were assessed before they started using the service. Staff were supported through induction, training, regular supervision and annual appraisals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported to maintain a healthy balanced diet and had access to healthcare professionals when they needed them.

People's privacy, dignity and independence was promoted. People and relatives told us staff were kind and caring.

People and relatives spoke positively about the service and said they felt safe. People received person centred care, which met their needs and preferences. The service had a complaints procedure in place. No one at the service was receiving end of life care.

There were systems in place to monitor the quality and safety of the service. The service worked in partnership with health and social care providers to plan and deliver an effective service. The service took the views of people and their relatives into account.

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 11 October 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.

Why we inspected

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

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.

Soma Healthcare (East London) provides personal care to people in their own homes in the community. At the time of our inspection, 46 people were receiving personal care from the service.

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

During this inspection, we found the service failed to make sufficient improvements to address the concerns identified at the last inspection and comply with our regulations. There was unclear information in relation to the support people received with their medicines. Risks to people’s health and safety were not effectively assessed. Although the majority of people and relatives told us staff were punctual, there were some instances of lateness and staff not staying the full duration of their calls. People’s care records did not reflect the appropriate support needed in accordance to people’s specific needs. The current systems in place were not effective enough to ensure complete and contemporaneous records were held in relation to people’s care.

The majority of people and relatives spoke positively about the quality of service they received. They told us they felt safe and staff knew their needs well. Staff followed appropriate infection control practices. The provider had systems in place to record and respond to accidents and incidents. Any lessons learnt were used as opportunities to improve the quality of service.

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 22 July 2019) and there was a breach of regulation in relation to medicines management.

The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.

At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

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 and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service remains requires improvement. 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 Soma Healthcare East London on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Soma Healthcare (East London) is a domiciliary care service that provides care and support to 75 people living in their own houses or flats in the community. 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

Medicines were not managed safely. There was a lack of oversight of medicines management, and we could not be assured that people were receiving their medicines as prescribed.

Assessments were carried out to ensure people's needs could be met. Where risks were identified, there was guidance in place for staff to ensure that people were safe. However, there were some instances, where guidance was not detailed enough.

There were appropriate numbers of suitably skilled staff available to meet people's needs. However, we received some feedback about instances of staff lateness and timekeeping issues at the weekends.

The majority of people spoke positively about the service. They said they felt safe and their needs were being met. Care and support was personalised to people’s individual needs.

The provider had systems in place to record and respond to accidents and incidents in a timely manner. Any lessons learnt were used as opportunities to improve the quality of service.

Staff followed appropriate infection control practices.

Staff had the knowledge and experience to support people's needs. They were supported through induction, training and supervision to ensure they performed their roles effectively.

People were supported to maintain good health and were supported to access healthcare services when needed.

People were encouraged to eat healthy food for their wellbeing.

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

People's privacy, dignity and independence was promoted. People told us staff were kind and caring.

There were procedures in place to respond to complaints. The provider had investigated and responded promptly to any concerns received.

There were systems in place to assess and monitor the quality of the service provided.

The provider worked with healthcare services and professionals to plan and deliver an effective service.

Rating at last inspection (and update)

The last rating for this service was Good (published 22 December 2016). Since this rating was awarded the registered provider of the service has moved premises. We have used the previous rating Good to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to the safe management of medicines 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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

Soma Healthcare (East London) 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 personal care and support to 145 people in the London Borough of Tower Hamlets and in Essex. 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.

The provider had a medicines policy in place where care workers were only allowed to prompt people’s medicines. People who required assistance with the administration of their medicines received support from relatives or health care professionals. Staff had completed basic training in medicines and knew what to do if they had any concerns.

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. Staff had received training in safeguarding adults from abuse and had a good understanding of how to identify and report any concerns.

The provider had a robust staff recruitment process and staff underwent 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’s risks were managed and care plans contained appropriate risk assessments which were updated when people’s needs changed. Where necessary, guidance was in place to enable staff to support people safely.

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 always ensure where appropriate, that documentation was in place for representatives to sign people’s care plans to agree with the care to be provided.

Care workers received an induction training programme to support them in meeting people’s needs effectively and were introduced to people before starting work with them. They shadowed more experienced staff before they started to deliver personal care independently.

Care workers told us they notified the care team and people’s relatives if they had any concerns about people’s health and we saw evidence of this in people’s care records. We also saw people were supported to maintain their health and well-being through access to health and social care professionals, such as GPs, district nurses and social services.

Care workers were aware of people’s dietary needs and food preferences and this was highlighted in people’s care records.

People were actively involved in making decisions about their care. People told us that staff respected their privacy and dignity and promoted their independence.

People and their relatives told us care workers were kind 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 concern for people’s health and welfare.

The provider made sure people were involved in 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 updated on people’s current condition.

There were monitoring systems in place to allow people and their relatives the opportunity to feedback about the care and treatment they received. People and their relatives knew how to make a complaint and were confident their concerns would be listened to and dealt with.

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 communication with people and care workers, supervision and a programme of other checks and audits of the service.

The service promoted an open and honest culture. People who used the service and their relatives were confident in the management team. Staff felt well supported by the registered manager and the care team and were confident they could raise any concerns or issues, knowing they would be listened to and acted upon.

We made one recommendation in relation to staff ensuring consent was sought in line with the principles of the Mental Capacity Act 2005 (MCA).