Background to this inspection
Updated
12 February 2019
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 was 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.
The inspection took place on 27 December 2018. This was an announced inspection, which meant the registered provider knew we would be visiting. We gave the provider 48 hours’ notice. This was because it was a domiciliary care agency and we wanted to make sure that the registered manager, or someone who could act on their behalf, would be available to support us with our inspection. The inspection team consisted of one adult social care inspector and an expert by experience, who made telephone calls to people who used the service. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Prior to the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, such as what the service does well and improvements they plan to make. Before our inspection we reviewed information we held about the service. This included any concerns or notifications of incidents that the provider had sent us since the last inspection. We also spoke with commissioners to obtain their feedback about the service.
During the inspection, we spoke with the registered manager, a nominated individual (regional manager), a quality compliance officer, a care coordinator, a roster and referrals officer and four care staff. We spoke with six people who used the service and six relatives.
We looked at thirteen people’s care records and other records relating to the management of the service. This included ten staff recruitment records, training documents, rotas, accident and incident records, complaints, health and safety information, quality monitoring and medicine records.
Updated
12 February 2019
This comprehensive inspection took place on 27 December 2018 and was announced.
This was the first inspection since the provider re-registered the service with the Care Quality Commission on 1 November 2017. We found the service compliant with health and social care regulations and have rated the service 'Good'.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults.
Not everyone using Havering (Carers Trust East Midlands) receives regulated activity; the CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
At the time of our inspection, 115 people were using the service but not all received personal care. Most people using the service received respite care from staff. This meant the person’s primary carer, who was usually a relative, took a short break while a member of staff looked after them. The provider employed 56 care staff, who visited people living in the local community.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered care homes, 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 received care that was safe. Safeguarding procedures were in place and staff knew how to protect people from abuse.
Risks to people were assessed and monitored so that these risks were mitigated against. The management team carried out regular checks on staff providing care in people’s homes, to ensure they followed the correct procedures and people always received safe care.
There was an accident and incident procedure for reporting incidents. We have made a recommendation about reviewing incidents to minimise reoccurrence in future because some incident records did not detail how they would ensure incidents are not repeated.
When required, staff administered people’s medicines and recorded medicines that they administered on people's Medicine Administration Records (MAR). They had received training on how to do this. Staff had received training in infection control and followed procedures when providing personal care.
The provider had sufficient numbers of staff available to provide care and support to people. Staff were recruited appropriately and the necessary pre-employment background checks were undertaken to ensure they were suitable for the role and were safe to provide care to people.
Staff received support from the management team with regular supervision meetings to discuss any concerns or issues. Staff received training to ensure the care and support they provided to people was effective.
The provider was compliant with the principles of the Mental Capacity Act 2005 (MCA). People provided their consent to care.
Staff felt confident in approaching the management team with any issues that needed to be addressed.
People's care and support needs were assessed and reviewed regularly. People were registered with health care professionals, such as GPs and staff contacted them in emergencies or if there were concerns about people's health. Staff provided people with meals and drinks when they requested to maintain their health and nutrition.
People were treated with respect by staff and their privacy and dignity were maintained. They were listened to by staff and were involved in making decisions about their care and support.
Care plans were person centred. They provided staff with suitable and relevant information about each person’s individual preferences and communication needs in order to obtain positive outcomes for each person.
A complaints procedure was in place but the service had not received any formal complaints. People and their relatives told us they knew how to complain and give feedback about their care.
Quality assurance procedures were in place to monitor the service. Feedback was received from people and relatives to check they were satisfied with the service and to help make improvements.