Archived: High Barnet

During our inspection on 11 October 2013, we found that the provider did not have proper steps in place to protect people who used the service against the risk of receiving care or treatment that was inappropriate or unsafe, by means of the delivery of care in such a way as to meet people's needs and ensured the welfare and safety of people.

Our inspection on 11 October 2013 also found that the provider did not make suitable arrangements to ensure that people who used the service were protected against the risks associated with the unsafe use and management of medicines, by means of the making of appropriate arrangements for the handling, using and safe administration of medicines. We also found that the provider did not operate effective recruitment procedures in order to ensure that people employed were of good character. We found that there were no suitable arrangements in place, to ensure that care workers received appropriate supervisions and appraisals. We also found that the provider did not have effective and accurate records of personal care and regular monitoring and assessment of the care provided to people who used the service.

During our inspection on 15 January 2014 we saw that the provider had updated care plans and risk assessments for people who used the service. Staff had received training in the administration of medicines and appropriate procedures in regards to the support provided when staff administer medicines. Appropriate documents for care workers had been obtained and efforts had been made to obtain references. A system of providing supervision to care workers had been implemented and regular supervisions were now provided to care workers and office staff. Care and staff records were up dated and regular telephone monitoring had been implemented, which ensured that care was regularly assessed and monitored.

We also sampled five care records, six staff files, training records and other records we requested during this inspection.

Relatives told us that they were happy with the care provided and care workers had the appropriate skill to support the person.

Care records viewed were not always detailed and information about how care and support was to be carried out was not planned sufficiently, this put people at risk of their needs not being met.

Risk assessments for medicines administered by staff were not in place, leaving staff and people using the service at risk of inappropriate administration of medicine.

The provider did not always follow up references and allocated care workers to support people who used the service, without clear evidence of them being fit to work with vulnerable adults and children.

The lack of induction and training records during this inspection and our previous inspection in January 2013, does not demonstrate that care workers received appropriate training to perform required care tasks safely. However staff told us that they felt supported by the agency and had received inductions and training to perform care tasks required of them.

Overall, records were found to be incomplete, not sufficiently detailed and in some instances not in place. This puts people at risk of not being protected against unsafe or inappropriate and inconsistent care and treatment.

Four care staff we spoke with were aware of the importance of treating people with respect and dignity regardless of their diverse backgrounds. Relatives of people indicated that care staff were reliable and competent. Staff informed us that they had been provided with essential training and they felt supported by their manager.

The agency had arrangements for ensuring that people are safeguarded and protected from abuse. Staff informed us that training in safeguarding people had been provided.

Some essential care and monitoring records were not available. These were needed to provide evidence that care was regularly reviewed and carefully monitored. This may place people at risk of not receiving appropriate care.