This inspection took place on 9 August and 10 August 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. This was their first inspection under this registration with the Care Quality Commission.Supporting Care 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 40 people in the London Boroughs of Tower Hamlets, Camden and Newham. The majority of people who used the service and the care workers who supported them used Bengali to communicate with each other. 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’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 staff 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 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.
The provider had a medicines policy in place where care workers were only allowed to prompt people’s medication. People who required assistance with 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, which ensured people received their medicines safely. The provider was aware that if they increased the level of support they gave to people with their medicines staff training and recording procedures would need to be updated.
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 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 were aware of people’s dietary needs and food preferences and this was highlighted in people’s care records. Care workers told us they notified the management 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, occupational therapists, district nurses and social services.
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 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 updated on people’s current condition.
People and their relatives were actively encouraged to express their views during assessments and reviews and were involved in making decisions about their care and whether any changes could be made to it. There was evidence that information about people’s care was translated into their first language so the information was accessible and understood by people who used the service.
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 regular satisfaction surveys in place to allow people and their relatives the opportunity to feedback about the care and treatment they received.
The service promoted an open and honest culture. Staff felt well supported by the management team and were confident they could raise any concerns or issues, knowing they would be listened to and acted upon.
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 of the service.
There was visible leadership from the management team and people who used the service and their relatives were confident in the running of the service, although there was one safeguarding incident that had not been notified to us. This incident was an alert and not substantiated.
We made one recommendation in relation to staff ensuring consent was sought in line with the principles of the MCA.