24 January 2018
During a routine inspection
Brook Domiciliary Care is a domiciliary care agency. It provides personal care to people living in their own homes and flats. It provides a service to older adults, younger adults, people living with dementia and people with a sensory impairment. Not everyone using Brook Domiciliary Care received a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care', such as help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
Brook Domiciliary care provided the regulated activity of personal care from an office based in Ilford, Essex. At the time of this inspection, 50 people were using the service. All the people who used the service received direct payments from the local authority and had chosen to use the service.
A registered manager was 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.
Staff supported people at home with their care needs and the service had assessed some risks. However, not all risks associated with people’s health care tasks had been assessed to ensure they were safe at all times, when staff carried out personal care. Although people received their medicines, records maintained by the service were not always clear, regularly reviewed and appropriately maintained by the service.
Quality assurance systems were in place but were not always effective. The audits, which the service carried out, had not identified the shortfalls we found during the inspection to ensure people received a consistently safe service.
Care plans were inconsistent. Some care plans did not include the support people would require in relation to their current circumstances. Care plans contained information on how to communicate with people. Pre-assessment forms had been completed in full to assess people’s needs and their background. Reviews were being carried out regularly. We have made a recommendation for the registered manager to review and update all the care plans with regard to supporting people based on their condition and current circumstances
People received safe care. Staff recruitment processes were followed and ensured that people were protected from being cared for by unsuitable staff. There were enough staff to provide care and support to people to meet their needs safely. Staff were trained in procedures to support and protect people from abuse.
People were supported to maintain good health and nutrition. Staff were equipped with sufficient personal protection equipment to reduce the risk of infection and cross contamination when supporting people with their personal care.
People received effective care and support. Staff received induction and on-going training for their role and understood their responsibilities to perform their roles effectively.
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 received good care from staff. They had developed positive relationships with the staff who understood their needs. Staff were kind, caring and treated people with dignity and respect.
Staff worked in a flexible way which promoted continuity of care so that they could meet people's needs in a person centred way. The registered manager ensured the management team provided staff with the support they needed.
People knew how to raise a concern or to make a complaint. The provider had a complaint policy and complaints received were investigated in accordance with this policy.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.