Archived: Care Support Newham Branch

Care Support Newham Branch is a domiciliary care agency that was providing personal care to 156 people at the time of the inspection.

People’s experience of using this service:

People who used the service told us they were kept safe and their relatives confirmed this was the case as well.

People were safeguarded from the risk of abuse at the service and staff knew how to whistle blow if they witnessed poor practice.

Risk assessments were in place to protect people from known risks and staff were always aware of risk when in people’s homes.

Safe recruitment practices were followed to ensure staff were safe to work with the people they cared for.

Safe medicine practices were followed. People told us they were reminded to take their medicines on time where needed and staff observed this had been done.

People told us they were supported by competent and knowledgeable staff who had received appropriate training for their role.

People were involved in the initial assessment of needs to ensure the service could fully support them.

Consent to care and treatment was sought and documented before care began.

People were encouraged to make their own choices in relation to their care and to remain as independent as possible.

People were supported to attend health appointments and the service worked closely with professionals to ensure people’s health needs were met.

People received support with light meal preparation.

People said the care staff were kind and to them and respected their privacy and dignity.

People’s religious needs equality and diversity was respected.

Care plans contained people’s preferences, communication needs, likes and dislikes.

People told us they were always involved in decision making and the progress of their care.

People gave positive feedback about the management of the service and the service they received.

People and their relatives knew how to make complaints about the service and these were responded to and resolved in a timely manner.

We made one recommendation about the management of equipment and recording safety checks.

Rating at last inspection:

At the last inspection the service was rated Requires Improvement (published 3 May 2018).

Why we inspected:

This was a planned comprehensive inspection based on CQC's scheduling process to check the safety and quality of care people received.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

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

Care Support Newham Branch is a domiciliary care agency. It provides personal care to people living in their own homes. Most of the people receiving a service are older adults. At the time of our inspection they were providing care to approximately 140 people.

There was 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 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.

At the last inspection in November 2016 we issued the provider with three warning notices which required them to address breaches of our regulations regarding safe care and treatment, person centred care and good governance. The provider had taken steps to address our concerns about governance and person-centred care, but issues with the safety of the service remained.

Risks to people were identified through the care plan assessment and review process. However, the measures in place to mitigate risk lacked detail and were not always clear.

People were supported to take medicines by their care workers. However, the systems in place did not ensure this was managed in a safe way as there were discrepancies between the information held in care files and medicines records. Medicines records were not always complete.

The provider had completed work to improve the quality and detail in care plans. However, the level of information varied and not all plans contained sufficient detail to ensure people received personalised care. The provider demonstrated they understood the level of detail required. They submitted updated plans and an action plan to ensure all care plans contained the required level of detail.

The provider had not submitted all the notifications they were required to submit to us by law.

The quality assurance and improvement systems were not effective in fully addressing the concerns identified at the last inspection. However, the registered manager responded positively to our feedback and submitted a creditable and realistic action plan following the inspection.

People told us they were visited by regular care staff. Records showed care was not always delivered on time and the provider recognised they faced challenges with the number of staff employed at specific times of the year. Staff were recruited in a way that ensured they were suitable to work in a care setting.

People felt safe with their care workers. Staff had a good understanding of safeguarding adults from avoidable harm and abuse. The provider had systems in place that ensured action was taken in response to incidents and allegations of abuse.

People were protected by the prevention and control of infection and staff told us they were well supplied with personal protective equipment.

People’s abilities and preferences in relation to their care were assessed through a comprehensive needs assessment process which was reviewed regularly. Care plans contained information about people’s religious beliefs, cultural background and personal history. The provider did not explore the impact sexual orientation may have on people’s experience of care. We have made a recommendation about ensuring the service is following best practice for people who identify as lesbian, gay, bisexual and transgender.

People told us care workers supported them to prepare and eat their meals. Care plans contained details of people’s dietary preferences. Where people were at risk of not eating enough to maintain sufficient nutritional intake care workers maintained records of what people ate to assist healthcare professionals in providing support.

People told us care workers supported them when they were unwell. Care plans contained information about people’s healthcare diagnosis and the contact details of relevant healthcare professionals were available to staff.

People consented to their care and told us their care workers offered them choices. Where people lacked capacity to consent to their care the provider followed the principles of the Mental Capacity Act 2005.

People told us their care workers were kind and treated them with compassion in a way that upheld their dignity. People’s preferences with regard to the gender of their care worker were respected.

People knew how to make complaints if they needed to. Records showed the provider responded to complaints in line with their policy and procedure.

The provider’s approach to end of life care was task focussed. However, they were in the process of training and developing their approach to providing end of life care.

People and staff spoke highly of the registered manager. The registered manager told us they valued their staff and thought they demonstrated appropriate values to work in a care setting.

The registered manager worked with other local organisations and managers from within their own organisation to ensure the service was continuously developing.

We identified two breaches of regulations regarding safe care and treatment and notifications. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for the service is Requires Improvement. This is the second consecutive time the service has been rated Requires Improvement.

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 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.

At this inspection we found three breaches of the Health and Social Care Act 2008 (regulated activities) Regulations 2014 regarding risk assessments, support planning and governance. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after representations and appeals have been concluded.

People were at risk of harm and poor support because risk assessments did not give guidance to staff on how to manage and mitigate risk for people. Support plans were not personalised and lacked detail. The service had not identified the issues we found at the time of inspection.

Staff received up to date training, supervision and appraisal. Staff had a good understanding of application of the Mental Capacity Act (2005). We found recruitment checks were in place to ensure new staff were suitable to work at the service. Staff had positive views about the leadership and staff culture of the service.

People and their relatives told us they felt safe using the service. Staff knew how to report safeguarding concerns. Medicines were administered safely. People using the service had access to healthcare professionals as required to meet their needs.

Staff knew the people they were supporting. People using the service and their relatives told us the service was caring. Staff respected people’s privacy and encouraged independence. People and their relatives knew how to make a complaint. The service supported people to maintain their culture and religious practices.

We found the provider had undertaken the appropriate checks on staff before they started work with the agency and delivered care to people. We found staff were supported in their roles, there was evidence care workers had regular supervisions and a yearly appraisal. People told us they felt staff were "good" at their jobs.

We found care worker's and people's records were securely kept and located promptly when we requested them. The provider had a policy in place for the management and archiving of people's records.