Care Assist in Harrow (Whitehall Road)

Updated 21 April 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Care Assist in Harrow (Whitehall Road) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission (CQC). This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection visit, we reviewed information we had received about the service since the last inspection. This included information about incidents the provider must notify us of, such as any allegations of abuse. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

People in the home had mental health needs and could not always communicate with us and tell us what they thought about the service. We therefore spent time at the home observing the experience of the people and their care, how the staff interacted with people and how they supported people during the day. We met all people who lived in the home and spoke with three of these people about their experience of the care provided. We also spoke with members of staff, including the registered manager, deputy and two care staff.

We reviewed a range of records. This included three people’s care records, medication records for five people, staff training records, two staff files in relation to recruitment, and incident and accidents records. We also reviewed a variety of records relating to the management of the service, including quality assurance audits and checks and records relating to the safety of the premises.

After the inspection

We also spoke with one care staff. We also continued to seek clarification from the provider to validate evidence found. We looked at training data, medicine protocols, training records, policies and quality assurance records.

Updated 21 April 2020

About the service

Care Assist in Harrow (Whitehall Road) is a small care home registered to provide accommodation and support with personal care for six people with mental health needs. At the time of this inspection, six people lived in the home.

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

We checked the arrangements in place in respect of medicines. Care workers completed medicines management training and policies and procedures were in place. Medicines Administration Records (MARs) we looked were completed with no unexplained gaps. However, we noted that one person was prescribed medicines on a when required basis. At the time of the inspection we noted that there was no clear guidance in place to advise staff on when and how to give these medicines. Following the inspection, the registered manager sent us these protocols. We made a recommendation in respect of this.

Staff were patient and respectful when interacting and supporting people. There was a relaxed atmosphere in the home. We observed people were at ease when in the presence of staff. Staff adopted a caring, friendly and professional approach in their work.

People were protected from abuse by staff who understood how to identify and report any abuse concerns. Risks to people's health and wellbeing had been assessed. Risk assessments were in place and included guidance for staff on how to minimise risks to people.

Appropriate recruitment checks had been carried out. The home had adequate staffing levels and staff were able to attend to people's needs.

The premises were clean and tidy. There was a record of essential maintenance carried out. Appropriate fire safety arrangements were in place. Steps had been taken to protect people from the risk of infections.

Staff received appropriate training and they had the knowledge and skills to support people and were supervised. Staff spoke positively about their experiences working at the home. They said that there was good teamwork in the home and they received support from the registered manager.

Staff supported people to have a healthy and nutritious diet that was in line with their individual dietary needs and preferences.

Staff understood their obligations regarding the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still

in the person's best interests. DoLS authorisations were in place where appropriate and where these had expired, the registered manager had notified the appropriate authority.

Staff and management understood the need to promote equality and diversity and considered people’s protected characteristics.

People’s care plans supported a person-centred approach. People received support to lead lifestyles of their choosing, access the local community and participate in recreational activities.

An appropriate complaints procedure was in place. We noted that since the last inspection, the service had not received any formal written complaints.

The service had an open and inclusive culture. The home was managed effectively. Management monitored the quality of the services and safety of the service to ensure it remained safe for people. Quality assurance systems were in place to enable management to monitor and improve the quality of people’s care.

Rating at last inspection

The last rating for this service was good (report published on 20 October 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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