Archived: Westminster Homecare Limited (Enfield/Waltham Forest)

Updated 20 April 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 8th January 2015 and it was announced. We spoke with eleven people who used the service, two relatives, six care staff, two field care supervisors, a senior care co-ordinator, the quality assurance officer, the medication auditor, the recruitment officer, the training manager, the manager and the operations manager. We reviewed a range of records. These included the care documentation of seven people, seven recruitment records of staff, staff training and induction records. We checked eleven people’s medication records and the quality assurance checks and audits that were completed.

Before our inspection, we reviewed information we held about the service. This included notifications submitted and safeguarding information received by us. We contacted six health and social care professionals to obtain their views about the care provided.

Updated 20 April 2015

We undertook an announced inspection of Westminster Homecare Limited (Enfield/Waltham Forest) on 4 February 2015. We told the provider two days before our visit that we would be visiting. We gave the provider notice of our inspection as we needed to make sure that someone was at the office in order for us to carry out the inspection. The inspection was carried out by two inspectors.

Westminster Homecare Limited (Enfield/Waltham Forest) is a domiciliary care agency providing a service to people living in the London boroughs of Enfield and Waltham Forest.

The service did not have a registered manager. The current manager had applied for registration and was awaiting the outcome of her application. 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 of the Health and Social Care Act and associated Regulations about how the service is run.

People informed us that most of the time they were satisfied with the care provided. People stated that the agency’s care staff were mostly competent and capable except on occasions when they had new staff. One person said, “They are very kind. They do everything they can.” Another person told us, “I am happy with my carers. They do a good job.” One relative stated, “I am happy with the carers provided for my relative. They are respectful. However, I had to call the manager today as the carer did not do the work properly this morning. The manager asked the carer to come back this afternoon.”

People had been comprehensively assessed and their choices and preferences had been recorded. Potential risks had been assessed and guidance was given to staff on how those risks could be minimised. Care plans were prepared with the involvement of people or their representatives. The care provided had been regularly monitored. There were reviews of people’s care arrangements with people and their representatives to ensure that the care provided met people’s needs.

There were arrangements in place to ensure that people people were administered their medication as prescribed and errors were spotted. We however, noted that there was no medication risk assessment for a person who was prescribed an anticoagulant medicine. This is needed to ensure the safety of people.

Staff had been carefully recruited and provided with induction and training they needed to enable them to care effectively for people. Staff had a good understanding of the needs of people. However some carers stated that occasionally they had not been fully briefed when visiting new people who used the service. Most people we spoke with informed us that their regular care staff understood their needs and they were satisfied with the care provided. A small number of people stated that new staff and staff at weekends were not always familiar with their care needs.

The service had a safeguarding policy together with the London guidance document “Protecting Adults at Risk: London Multi-Agency Policy and Procedure to Safeguard Adults from Abuse”. Staff had received training and knew how to recognise and report any concerns or allegation of abuse. Safeguarding concerns including complaints regarding medication errors had been reported to the safeguarding team and to the CQC. The service had responded promptly, co-operated with the safeguarding team and taken appropriate action to deal with them.

The manager and the staff team worked with other professionals to ensure people were well cared for. The feedback from professionals indicated that although the service had experienced problems with the quality of care provided in the previous year, the service had now improved and there were few complaints. A small number of people were dissatisfied with certain aspects of their care and stated that their complaints had not been adequately responded to. The manager informed us soon after the inspection that these had been dealt with.