Verity Healthcare - Waltham Forest

Updated 29 March 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

This inspection was carried out by two inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to children and adults living in their own homes.

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 a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to allow for the provider or registered manager to seek permission to contact people and their relatives for feedback about their experiences to support the inspection.

Inspection activity started on 31 August 2022 and ended on 23 November 2022. We visited the location’s office on 31 August 2022.

What we did before the inspection

Before the inspection we reviewed the information we held about the service including notifications they sent us. We asked for feedback from the local authority in which area the service is based.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with the assistant care manager and another member of the office staff, the registered manager and a representative of the provider.

We reviewed a range of records including two care plans and risk assessments, medicines records and daily notes. We looked at two staff recruitment and training records.

We looked at records related to the management of the service such as call monitoring records and audits.

On 5 and 7 September 2022, we spoke by phone with two people using the service to understand their experience of the service. We also spoke with two care workers by phone to understand their views about the service.

We sought feedback from two health professionals who the provider told us had worked with the service. We sought further information and clarification from the provider and registered manager.

Updated 29 March 2023

About the service

Verity Healthcare – Waltham Forest is a domiciliary care agency. The service provides personal care and support to adults and children in their own homes. Not everyone using Verity Healthcare – Waltham Forest receives 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. At the time of our inspection there were three children and one adult using the service.

The provider is also registered to provide another regulated activity, Treatment for Disease, Disorder and Injury but as recorded at the last inspection they advised us they were not delivering this at the time of our inspection and had not done so since the last inspection.

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

Improvements had been made since the last inspection in a number of areas in relation to the oversight and monitoring of the quality and safety of the service.

However, in some areas of training, staff did not always receive training in line with best practice requirements and guidance.

There was an absence of a robust system of oversight of staff training to ensure adequate checks on the validity of trainer’s qualifications met best practice requirements. The registered manager and a director of the service continued to state their training arrangements complied with guidance. However, they were unable to provide relevant evidence to assure us of this. We have referred our concerns to the relevant authorities.

Most risks were assessed and there were suitable risk management plans, but one risk assessment contained inaccurate information. An amended risk assessment was sent to us following the inspection.

Records related to people’s care were held across different phone apps and written records and it was difficult to be certain if staff were always guided about where to find all the information about people’s care. The provider recognised this and told us they were working to address this

People told us they felt safe using the service. Staff understood how to protect people from harm and how to raise concerns. The registered manager understood their role and responsibilities in relation to safeguarding adults.

There were enough staff to meet people’s needs and they received their care as planned. Safe recruitment practices were followed.

People told us staff followed good infection prevention practice, including the use of personal protective equipment, (PPE). Staff had received training on infection control. People were supported to maintain a balanced diet.

People's needs were assessed before they started using the service and they had a personalised plan for their care which reflected their individual needs and preferences. Staff told us they were supported in their roles through training and regular supervision.

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.

People told us they had the same small staff team who knew them well and they liked. People were complimentary about the staff who supported them. They told us they were treated with care, consideration dignity and respect.

People received care from staff who knew them well and respected their diverse needs. People told us they were involved in making decisions about the support they received and knew how to complain if they needed to.

Staff were positive about the support they received from the provider and registered manager. They told us they understood their roles and the registered manager was available and approachable.

People were complimentary about the service and told us they were consulted and involved in giving feedback through surveys or telephone calls.

There was a system to monitor other aspects of the quality of the service and identify any learning to make improvements. The provider showed us a new electronic system they were in the process of developing which they said would bring further improvements.

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

Rating at last inspection and update.

The last rating for this service was inadequate, (published 3 December 2021)

At this inspection we found improvements had been made but further improvements were needed.

At our last inspection we recommended that the provider consult best practice guidance in relation to the recording of medicines administration and risk assessments. At this inspection we found these recommendations had been acted on.

This service has been in Special Measures since 3 December 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Verity Healthcare - Waltham Forest on our website at www.cqc.org.uk.

The overall rating for the service has changed from Inadequate to Requires Improvement based on the findings of this inspection.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to staff training and the quality monitoring of the service at this inspection.

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.