Home Instead Enfield

Updated 19 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We gave the service four days’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or visiting people who used the service. We needed to be sure that they would be in.

The inspection was carried by one inspector and one expert by experience who made telephone calls to people and relatives to obtain feedback. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provided had submitted a PIR, as requested.

We only managed to speak with one person who used the service as the remaining people were either unable to or found it difficult to speak over the phone. We spoke with six relatives. We spoke with a company director, registered manager, care co-ordinator and four care staff.

We looked at four people’s care plans and other documents relating to their care including risk assessments and medicines records. We reviewed four staff files. We looked at other records held at the office including staff meeting minutes as well as health and safety documents and quality audits.

Updated 19 July 2018

This announced inspection took place on 24 May 2018.

Home Instead Enfield is a domiciliary care agency based in Enfield, North London. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, many of whom are living with dementia. Eleven people were receiving personal care at the time of inspection.

This was the first inspection since the service registered in May 2017.

There was a registered manager in place. 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.

Relatives spoke positively of the dedication and passion of the management team to ensure their loved ones lived as full a life as possible. The registered provider had developed strong links with the local community. They worked alongside other social care organisations to promote social care causes and make improvements. The registered manager and management team carried out regular checks and audits to ensure that the people were receiving high quality care.

People and relatives praised the caring and compassionate nature of the care staff. The provider supported staff to understand the emotional and social needs of people living with dementia and was actively involved in achieving positive local outcomes to improve the quality of life for people living with dementia.

People and relatives told us they felt safe. Procedures and policies relating to safeguarding people from harm were in place and accessible to staff. All staff had completed training in safeguarding adults and demonstrated an understanding of the different types of abuse to look out for and how to raise safeguarding concerns.

Detailed risk assessments were in place for people using the service and were reviewed and updated regularly. Risk assessments explained the signs to look for when presented with a possible risk and the least restrictive ways of mitigating the risk based on the individual needs of the person.

Medicines were managed safely. Staff had completed medication training and the service had a clear medication policy in place which was accessible to staff. There were regular medicines audits in place.

The provider employed sufficient skilled and experienced staff to meet people's needs. We saw evidence of a comprehensive staff induction and on-going training programme. Staff were recruited with necessary pre-employment checks carried out. Staff received regular supervisions and annual appraisals.

Care plans were person centred and reflected what was important to the person. Care needs were regularly reviewed and updated to meet the changing needs of people who used the service.

People and their relatives told us they received kind and compassionate care and were treated with respect.

All staff had received training on the Mental Capacity Act (2005) and staff understood what to do if they had concerns around people's mental capacity.

People were supported to maintain good health and had access to healthcare services. People were supported to be independent and access the community, where possible.

There was a complaints procedure in place and people and relatives confirmed that they knew how to complain. The provider actively sought feedback from people and relatives.