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Archived: Chenash HomeCare Specialists

Overall: Good read more about inspection ratings

17 Lindores Road, Carshalton, Surrey, SM5 1BQ (020) 8648 6400

Provided and run by:
Mr Fafe Fainosi Mudzingwa

Important: The provider of this service changed. See new profile

All Inspections

24 November 2016

During a routine inspection

This inspection took place on 24 November 2016 and was announced. The last Care Quality Commission (CQC) comprehensive inspection of the service was carried out in October 2015. We gave the service an overall rating of 'requires improvement' because we found the provider was in breach of the regulations. This was because they had not sent CQC statutory notifications about events or incidents that had occurred, involving people using the service, which they were legally required to do. We did not identify any further breaches but we found some aspects of the service were inconsistent. There were gaps in employment checks undertaken by the provider, some aspects of medicines management did not reflect best practice and the quality of records maintained by the service was inconsistent. We asked the provider to take action to make improvements in respect of the breach in regulation. We went back to the service in March 2016 to check that improvement had been made and found this regulation was being met.

Chenash Homecare Specialists is a small domiciliary care agency which provides personal care and support to people in their own homes. At the time of our inspection there were 35 people receiving personal care from this service, the majority of whom were funded by their local authority. People using the service were mostly older adults who had a wide range of healthcare needs and conditions. The package of care and support provided to each person varied between a few hours a week to several times a day, depending on their specific needs.

The service had a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

At this inspection we found the provider had continued to maintain the improvements made in respect of prompt submission of statutory notifications. Records of events and incidents maintained by the service matched the information we held on our records.

We found improvements had been made to the management and maintenance of records. Staff now had access to all the information they needed to support people, in one central record. Records the provider maintained about staff contained appropriate information. These now contained evidence of the support staff received through supervision (one to one meetings).

The provider had improved their recruitment practices. Appropriate employment and criminal records checks had been carried out all new staff to ensure they were suitable and fit to work for the service.

We also found improvements had been made to the way staff recorded information about medicines. The provider had updated their medicines policy after our last inspection. They had provided training and support to all staff to ensure the service maintained a clear, accountable record for when and by whom medicines had been administered.

People felt safe with the support provided by the service. Staff were supported to take appropriate action to ensure people were protected if they suspected they were at risk of abuse or being harmed by discriminatory behaviour or practices. Risk of injury or harm posed to people by their specific healthcare needs and home environment had been assessed. Plans were put in place which instructed staff on how to minimise identified risks to keep people safe.

The registered manager planned and managed all scheduled visits to people, taking account of their specific care and support needs. This enabled them to ensure appropriately skilled staff were assigned to meet these safely. The majority of people said staff attended scheduled visits on time. This indicated there were sufficient numbers of staff to meet people’s needs. Staffing levels and the timeliness of scheduled visits was continuously monitored by the registered manager. The registered manager, wherever possible, scheduled visits so that people received support from the same members of staff, in order to experience consistency and continuity in their care.

People were involved in discussions about their care and support needs. People’s support plans set out how their needs should be met by staff and reflected their individual choices and preferences. Plans were regularly reviewed to identify any changes that may be needed to the support people received. People said staff were able to meet their needs. They told us staff were kind, caring and respectful. People’s right to privacy and to be treated with dignity was maintained by staff, particularly when receiving personal care. People were encouraged to do as much as they could and wanted to do for themselves to retain control and independence.

Staff received training to meet people’s needs. Training was in areas and topics relevant to their work. The provider and registered manager monitored training to ensure staff skills and knowledge were kept up to date. Staff received regular supervision so that they were appropriately supported to care for people.

People were supported by staff to maintain their health and wellbeing. Staff helped people to take their prescribed medicines when they needed these. They monitored people’s general health and wellbeing and where they had any issues or concerns about this they took appropriate action so that attention could be sought promptly from the relevant healthcare professionals. Where the service was responsible for this, people were supported to eat and drink sufficient amounts.

The majority of people were satisfied with the care and support they received. People knew how to make a complaint if needed. The provider sought the views and experiences of people and their relatives about the quality of care and support provided and how this could be improved. Since our last inspection the provider had extended this to include the views of health and social care professionals that worked closely with people. The provider used this information along with other checks to assess and review the quality of service people experienced. Where there were any shortfalls or gaps identified through these checks the provider and registered manager took action to address these.

We checked whether the service was working within the principles of the Mental Capacity Act (MCA) 2005. Staff were fully aware of their responsibilities in relation to the Act.

31 March 2016

During an inspection looking at part of the service

We carried out a comprehensive inspection of this service on 27 October 2015 at which a breach of legal requirements was found. The provider had not notified us of two incidents with regards to abuse or allegations of abuse in relation to people using the service and incidents reported to, or investigated by the police. After the inspection, the provider wrote to us with a plan for how they would meet the legal requirements in relation to this breach.

We undertook this focused inspection on 31 March 2016. We checked the provider had followed their plan and made the improvements they said they would to meet legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Chenash HomeCare Specialists on our website at www.cqc.org.uk

Chenash HomeCare Specialists is a small domiciliary care agency which provides personal care and support to people in their own homes. At the time of our inspection there were approximately 45 people receiving personal care from this service, which was funded by their local authority.

The service had a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

At this inspection we found the provider had taken appropriate action to ensure notifications they are legally required to submit to CQC were done so and without delay.

The provider had ensured all staff were aware of the service’s legal obligations about notifying CQC of events and incidents and how and when this should be done. They and the registered manager demonstrated a good understanding and awareness of their responsibilities for ensuring this was done without delay. Information about the process for submitting notifications was accessible to all staff.

The provider, through quality assurance checks, ensured notifications were submitted to CQC promptly when there had been an event or incident involving people using the service. Our own records showed the provider had fulfilled their legal obligations to submit notifications in a timely manner, following the last inspection.

27/10/2015

During a routine inspection

This inspection took place on 27 October 2015 and was announced. At the last inspection of the service in April 2014 we found the service was meeting the regulations we looked at.

Chenash HomeCare Specialists is a small domiciliary care agency which provides personal care and support to people in their own homes. At the time of our inspection there were approximately 45 people receiving personal care from this service, which was funded by their local authority.

The service had a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

During this inspection we found the provider in breach of their legal requirement to submit notifications to CQC. You can see what action we told the provider to take at the back of the full version of the report. We also identified some inconsistencies in the way the service maintained its records. We found physical records maintained about people and staff were in some cases incomplete.

There were some gaps in the checks the provider undertook to ensure new staff were suitable and fit to work for the service. However there were enough staff available to meet the needs of people using the service. The registered manager matched people with staff who were able to meet their specific needs and preferences. People said they experienced continuity and consistency as they had regular staff that supported them.

Some aspects of the way medicines were managed was not best practice. However, people received their medicines as prescribed. People were supported to stay healthy and well. Staff monitored that they ate and drank sufficient amounts and their overall health and wellbeing. Where they had any issues or concerns about this they took appropriate action so that medical care and attention could be sought promptly from the relevant healthcare professionals.

People and their relatives told us they felt safe with the care and support provided by the service. Staff had been trained to know what action to take to ensure people were protected if they suspected they were at risk of abuse. Risks to people’s health, safety and wellbeing had been assessed by the registered manager. Staff were given guidance on how to minimise any identified risks to keep people safe from harm or injury.

Staff received training to meet people’s needs. The registered manager and provider monitored training to ensure staff skills and knowledge were kept up to date. Staff were supported by the registered manager through supervision through which they were provided opportunities to discuss any issues or concerns they had about their work.

People’s consent to care was sought prior to care and support being provided. Where people were unable to make specific decisions about their care and support because they lacked capacity to do so, people's representatives and other professionals were involved in making these, in their best interests.

People and their relatives told us staff looked after people in a way which was caring and respectful. People’s right to privacy and dignity was respected and maintained by staff, particularly when receiving personal care. People were encouraged to do as much as they could and wanted to do for themselves to retain control and independence.

People’s support plans were reflective of their specific needs and preferences for how they wished to be cared for and supported. People and their relatives said they felt able to express their views and were listened to. Staff ensured people’s care and support needs were reviewed regularly to ensure staff had up to date information about people’s current care and support needs.

People and their relatives said they were comfortable raising any issues or concerns they had directly with staff and knew how to make a complaint if needed. People were confident that any complaints they made would be dealt with appropriately. They provider reflected on any learning from complaints and how this could be used to make improvements.

The provider was committed to improving the quality of care people experienced. This was embedded in the vision and values for the service. They used quality assurance mechanisms such as surveys, spot checks and reviews to monitor that expected standards were being delivered by staff. People’s views were sought through these checks in order to improve the service. But, the views of others such as external healthcare professionals were not routinely sought so the provider was missing opportunities to identify aspects of the service that could be improved. However they did use learning from investigations to drive continuous improvement.

24 April 2014

During a routine inspection

We considered our inspection findings to answer questions we always ask; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, from looking at records and from speaking with two people using the service, the relatives of two others and the staff supporting them.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The majority of people we spoke with felt safe receiving care and support from the service. Relatives of people using the service told us, 'I feel they are totally safe with their carer' and 'I feel confident they are safe.'

The registered manager had assessed potential risks to people's safety, health and welfare in their homes. There was appropriate guidance for staff on how to manage these risks to keep people safe from harm when they received care and support.

Staff received appropriate information and training on how to protect people from the risk of abuse, harm or neglect. Where concerns were identified the service acted promptly to notify the appropriate safeguarding authority.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The service had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and in how to submit one. This means that people will be safeguarded as required.

Is the service effective?

People using the service and their relatives were involved in planning and developing their care and support. Their views and experiences were used to develop their plan of care. Their specific needs were taken into account and staff demonstrated a good understanding and awareness of these.

Staff were responsive to any changes and deterioration in people's general health and well-being. They took appropriate action to ensure relevant healthcare professionals were kept informed about any changes so that people got the medical care and attention they needed.

Staff received regular and appropriate training to ensure they were able to meet the specific needs of people using the service.

Is the service caring?

People were cared for by kind and attentive staff. People we spoke with described the staff that supported them as patient, kind and pleasant. One person said staff were always keen and willing to help.

Is the service responsive?

People using the service and their relatives received appropriate information and support from the service. This helped them to make decisions about the care and support that was needed. People told us they were able to view and make comments to care plans before they were finalised so that these reflected accurately what people wanted.

All the people we spoke with told us they were comfortable raising any issues and concerns with the registered manager who dealt with these quickly.

Is the service well-led?

The views and experiences of people using the service and their relatives were sought by the service. People said the registered manager was approachable and always willing to listen to them.

The provider carried out regular checks to assess and monitor the quality of service provided. Complaints received by the service had been responded to and resolved to the complainant's satisfaction.