Whetstone Office

About the service

Whetstone Office, commonly known as Nationwide Care, provides personal care and support to people living in their own home as part of a supported living scheme. The service comprises several small houses or purpose-built flats (supported living units) where people have their own bedrooms and access to shared communal living areas. The service also provides support to people living in their own individual accommodation.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. 19 people were using the service at the time of the inspection, out of whom 10 people received personal care.

People’s experience of using this service and what we found

Right Support

The service supported people to have the maximum possible choice, control and independence. Staff supported people to make decisions, following best practice in decision-making.

Staff focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People had a choice about their living environment and were able to personalise their rooms.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative. Staff enabled people to access specialist health and social care support in the community.

Right Care

People received kind and compassionate care. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies. Staff had training on how to recognise and report abuse and they knew how to apply it.

People's care and support plans reflected their range of needs and promoted their wellbeing and enjoyment of life.

The service had enough appropriately skilled staff to meet people's needs and keep them safe.

Staff and people worked together to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right culture

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.

Staff knew and understood people well and were responsive to their individual needs. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

People and those important to them were involved in planning their care. The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people's views.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 30 April 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 16 February 2021 during which we found breaches in relation to safe care and treatment, fit and proper persons employed, and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Whetstone Office on our website at www.cqc.org.uk.

Recommendations

We made a recommendation for the provider to review their recruitment procedures to ensure these were in line with best practice.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Nationwide Care (Finchley) – Dollis Park Office is a domiciliary care service providing personal care to people with autism and learning disabilities living in a supported living setting. At the time of the inspection, the service was supporting three people in one supported living setting.

The service had been designed and developed considering best practice guidance and the principles and values underpinning Registering the Right Support. The location was located with close access to local shops, transport links and amenities such as parks and recreation grounds.

People’s experience of using this service and what we found

We found concerns in relation to recruitment. Full information about staff, as required by legislation was not always documented such as references and employment histories at the recruitment stage to enable safe decisions to be made.

We were not assured people received their medicines as prescribed as there were gaps in recording medicine administration. Regular audits were not carried out to ensure medicines stocks were correct. Staff had not had their competencies to administer medicines safely assessed.

We identified shortfalls in relation to infection prevention and control which placed people and staff at increased risk of harm given the COVID-19 pandemic.

There was no registered manager at the time of the inspection and since registration there had been a turnover of managers. This had impacted on quality of recordkeeping, care planning and assessing risk.

Quality assurance and auditing processes had not been developed and embedded which meant that concerns identified on the inspection had not been identified by the management team.

People and their families were positive around the support and care they received from staff and the management team. Staff were caring and kind and supported people to learn life skills and gain independence.

Staff knew the signs to look for if abuse was suspected and told us of the actions, they would take to protect people from abuse. There were enough staff on shift to meet people's needs.

People were supported to engage in a range of activities both within the home and in the community. People were supported to make healthy food choices which had a positive impact on their health and wellbeing.

People were supported with health and medical needs and staff engaged well with health and care professionals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 2 July 2020 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about staffing, training and management at the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to medicines management, infection prevention and control, staff recruitment and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.