Archived: Housing & Care 21 - Barnet

Updated 9 September 2016

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.

The inspection took place on 27 and 28 July 2016. This was an announced inspection. We gave the provider 48 hours notice of the inspection as this is a domiciliary care agency and we wanted to ensure the manager was available in the office to meet us.

Prior to our inspection, we reviewed information we held about the service, including previous reports and notifications sent to us at the Care Quality Commission. A notification is information about important events which the service is required to send us by law. We looked at the information sent to us by the provider in the Provider Information Return, 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. We contacted local authority commissioners and safeguarding teams about their views of the quality of care delivered by the service.

The inspection was carried out by one adult social care inspector, an inspection manager and three experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We spoke with the manager, operations manager, two care coordinators, one member of senior care staff and six care staff. Following our inspection, we spoke to 21 people and seven relatives.

We looked at 13 care plans and 11 staff files including recruitment, training and supervision records and one month’s staff rosters. We also reviewed the service’s statement of purpose, selected policies and procedures, accidents / incidents and complaints records, staff team meeting minutes, quality audits and spot checks and care delivery records for people using the service. We also reviewed the documents that were provided by the manager (on our request) after the inspection. These documents included the handling of people’s money and professional boundaries policies, updated supervision form and completed people’s feedback questionnaires.

Updated 9 September 2016

The inspection took place on 27 and 28 July 2016. This was an announced inspection. We gave the provider 48 hours notice of the inspection as this is a domiciliary care agency and we wanted to ensure the manager was available in the office to meet us. This service had not been inspected since its registration on 14 February 2014.

Housing and Care 21- Barnet is a domiciliary care service run by Housing and Care 21. The service provides personal care to over 300 people. They support people with dementia, mental health needs, a physical disability, learning disability or autistic spectrum disorder, sensory impairment and people who misuse drugs and alcohol. The service supports both older people and younger adults in their own homes. Housing and Care 21- Barnet offered two independent domiciliary care services. These included reablement service for a maximum of six weeks, and long term domiciliary care service. Housing and Care 21- Barnet were in the process of re-organising their services due to a change of funding from the local authority. At the time of inspection 310 people were receiving services and half of the people were receiving reablement services.

The service had a manager who had been recently appointed. They had applied for registration with the Care Quality Commission (CQC). Following the inspection, the provider told us the newly appointed manager had resigned from the role. The registered manager is a person who has acting with the CQC 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.

People using the service and their relatives told us they found staff caring and helpful. They told us that their individual health and care needs were met. People told us that staff respected their privacy and dignity. Staff were able to demonstrate their understanding of the needs and preferences of the people they cared for by giving examples of how they supported people.

Care plans were easy to follow and recorded individual needs, likes and dislikes. Risk assessments were individualised and detailed information on safe management of the risks. However, not all care plans and risk assessments were regularly updated and reviewed. There were gaps in the care delivery records. We checked medicines administration records (MAR) and found that clear and accurate records were not being kept of medicines administered by staff.

There were safeguarding policies and procedures in place. Staff were able to demonstrate their role in raising concerns. Staff had a good understanding of the safeguarding procedure and the role of external agencies.

Staff files had records of application forms, interview notes, criminal record checks and reference checks.

Staff told us they were supported well and we saw records of staff supervision and appraisals. Staff told us they attended induction training and additional training, and records confirmed this.

The service did not have robust systems and processes in place to assess, monitor and improve the quality and safety of service provided. There was evidence of regular monitoring checks of the service. However, the checks did not always pick up the gaps in the records.

We found that the provider was not meeting legal requirements and there were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to record-keeping and systems and processes to improve the quality of the services.

You can see what action we told the provider to take at the back of the full version of the report.