27 July 2016
During a routine inspection
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.