This inspection took place on 19, 22 and 26 April 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. At our previous inspection on 5 February 2014 we found the provider was meeting the regulations we inspected.Home and Community Services is a domiciliary care agency which provides personal care and support to people in their own homes. At the time of our visit the service was providing support to 184 people in the London Borough of Tower Hamlets. The majority of people who used the service and the care workers who supported them used Bengali as their first language. All of the people using the service were either funded by the local authority or the NHS.
There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (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 and their relatives told us they felt safe using the service and care workers had a good understanding of how to protect people from abuse. Staff were confident that any concerns would be investigated and dealt with. All staff had received training in safeguarding adults from abuse and had a good understanding of how to identify and report any concerns.
Risks to people were managed and care plans contained appropriate risk assessments which were updated when people’s needs changed. The service had a robust recruitment process and staff had the necessary checks to ensure they were suitable to work with people using the service. People had regular care workers to ensure they received consistent levels of care by staff who knew how to look after them.
There was a comprehensive induction based on the Care Certificate and a six month probation period for new staff. Staff members also took part in a training programme to support them in meeting people’s needs effectively and were always introduced to people before they started supporting them. They shadowed more experienced staff before they started to deliver personal care independently and received regular supervision from management. They told us they felt supported and were happy with the supervision they received.
Staff understood the principles of the Mental Capacity Act 2005 (MCA). Care workers respected people’s decisions and gained people’s consent before they provided personal care.
Care workers were aware of people’s dietary needs and food preferences. Care workers told us they notified the management team and people’s relatives if they had any concerns about people’s health and we saw evidence of this in people’s care plans. We also saw people were supported to maintain their health and well-being through access to health and social care professionals, such as GPs, occupational therapists and social services.
People and their relatives told us staff were kind and compassionate and knew how to provide the care and support they required. Care workers understood the importance of getting to know the people they worked with and showed concern for people’s health and welfare in a caring manner.
People told us that staff respected their privacy and dignity and promoted their independence. There was evidence that language and cultural requirements were considered when carrying out the assessments and allocating care workers to people using the service.
People and their relatives were involved in planning how they were cared for and supported. An initial assessment was completed from which care plans and risk assessments were developed. Care was personalised to meet people’s individual needs and was reviewed if there were any significant changes, with health and social care professionals being contacted to authorise changes in care received. People and their relatives were actively encouraged to express their views and were involved in making decisions about their care and whether any changes could be made to it.
People and their relatives knew how to make a complaint and were able to share their views and opinions about the service they received. There were quality monitoring visits, phone calls and surveys in place to allow people and their relatives the opportunity to feedback about the care and treatment they received. Feedback could be given in people’s own language.
The service promoted an open and honest culture. Staff felt well supported by the registered manager and management team and were confident they could raise any concerns or issues, knowing they would be listened to and acted on. The registered manager valued staff and appreciated the work they did.
There were effective quality assurance systems in place to monitor the quality of the service provided and understand the experiences of people who used the service. The registered managers followed a monthly, quarterly and annual cycle of quality assurance activities and learning took place from the result of the audits.