9 September 2014
During an inspection in response to concerns
At the time of the inspection 288 people were using the service and 184 staff worked for the service. The service covered three London local authorities and Berkshire where one person who used the service lived.
We carried out this responsive inspection due to the number of safeguarding cases that we had been notified of over the past six months and the concerns the Local Authority had about this service.
Feedback from people and relatives was mainly positive. They all confirmed the person's needs were assessed prior to receiving a service. The majority of the comments we received also confirmed that telephone monitoring had taken place to obtain their views and most people said a home visit was carried out to check on their needs. Most people said care workers arrived on time or they were contacted if they were running late. Comments included, 'I am emailed the staff rota so I know who is coming', 'Care workers (staff) know exactly how to move me safely' and 'care worker does all I ask them to do'. However, some feedback described care workers not being able to find their home and therefore they were often late when the regular care worker was not working. We also saw records which showed that some care workers visited people much earlier or much later than the agreed time which left people with longer and shorter than expected gaps until their next visit. Unplanned changes to people's visits could place a person at risk of unsafe or inappropriate care.
We looked at six people' care records. Some records contained support plans and risk assessments which gave sufficient details about meeting people's needs. Information such as gender care preference was also recorded. However, in some care records we found the information was not consistently recorded across support plans, risk assessments and the 'notes' section of the care records. The conflicting information could lead a carer to provide unsafe or unsuitable care to a vulnerable person if the care worker was not provided with clear details on how to support the person.
We viewed five care workers employment files. All the recruitment checks were in place including Identification, references, completed application forms, interview questions, criminal record checks and contracts. Care workers we asked confirmed they had attended an interview and all the required recruitment checks had been carried out.
Care workers received an induction to working at the service and on-going training on a range of subjects. Care workers were also provided with support such as staff meetings and checks on their work to ensure they had the skills to meet people's individual needs.
Various audits and reviews took place to ensure the service obtained the views of people using the service and to identify any improvements that needed to be made to the running of the service.