Johnstons Homecare Ltd

Updated 25 January 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post, but a new manager had been appointed who was planning to register with CQC. The newly appointed manager had been in post for 1 week at the time of the inspection.

Notice of inspection

We gave a short period notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we held about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service and 5 relatives about their experience of the care provided. We spoke with 6 members of staff including care workers, the manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records including 4 people's care records and medicines records. We looked at 4 staff files in relation to recruitment, training and supervision. A variety of records relating to the management of the service, including policies and procedures, complaints and audits were also reviewed.

Updated 25 January 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service

Johnston’s Homecare Ltd is a domiciliary care agency providing personal care and support to people living in their own homes. People’s needs were varied and included older people and people who had physical disabilities. At the time of the inspection, 21 people living in the north of London were using the service, out of whom, 17 people received personal care.

CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

Right Support:

While people received care from a consistent staff team, staff were not always recruited safely. We found issues with recruitment checks and staffing arrangements.

The service assessed risks to people’s health, care and welfare. However, there were discrepancies in risk assessments as not every risk was carefully assessed to ensure people received safe care and support.

Staff offered people choices and sought their views when providing care. Staff treated people with dignity while promoting their independence.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

People were safeguarded from abuse and staff were fully aware of their duties to report concerns. People received their medicines safely and as prescribed. There were infection prevention and control measures in place to protect people from the risk of the spread of infection.

People received a comprehensive assessment of their needs before they received care. People had access to healthcare when needed. Staff had clear guidance on supporting people to eat and drink as per their wishes.

People received person-centred care and support from a caring and respectful staff team. Staff received appropriate support to be able to perform their roles and provided good care to people.

Staff promoted equality and diversity in their support for people. They understood people's cultural needs and provided culturally appropriate care.

Right Culture:

Management oversight did not prove to be effective and quality assurance procedures were not robust enough as although some of the issues we found at this inspection had been identified, they had not been addressed in a timely manner.

The service had a system to manage complaints. People, their relatives and staff felt safe to raise concerns and share their views to the management. The provider worked in collaboration with other agencies to ensure people received appropriate and personalised care and support.

People and those important to them were involved in planning their care. People and their relatives were satisfied with the support they received from the management.

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

Rating at last inspection

This was the first inspection of this service. The service was registered with us on 18 December 2020 but did not provide a regulated activity until May 2022.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified a breach in relation to fit and proper persons employed at this inspection.

We made recommendations about staff deployment and assessing risks to people’s health, care and welfare.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.