15 September 2022
During an inspection looking at part of the service
Servesoul – Camden Office is a large domiciliary care agency that provides support to people in their own homes. It provides a service to predominantly older adults. At the time of our inspection there were 150 people using the service. People using the service lived in two London Boroughs in north and south London.
Not everyone who used the service received personal care. The Care Quality Commission (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
Staff had received training about safeguarding and knew how to respond to, and report, any allegation or suspicion of harm or abuse.
People’s care plans and risk assessments included information about their care and support needs and preferences. However, risk assessments did not always provide evidence that common risks, for example fire safety, had been considered. The provider had made changes to the risk assessment format which they showed us on the second day of the inspection and they told us that this will be implemented.
The recruitment procedures were designed to ensure that care staff were suitable for the work they would be undertaking. We viewed a sample of recruitment records for care staff employed since our previous inspection and found that background checks were being carried out.
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 and their family were involved in decisions about their care, which was evident in the care plans we viewed and from the feedback we received from people using the service and relatives. Since the easing of COVID-19 restrictions, the provider had begun to re-introduce face to face spot checks and meetings with people during visits to people’s own homes.
Information about people’s religious, cultural and communication needs was included in their care plans.
People were asked about their views of the care and support that they received using telephone calls, feedback questionnaires and during visits to people at their own home.
Some things worked well but there were risks that this could be undermined as management oversight was not diligent enough to prevent avoidable mistakes being made. Improvement was required to the oversight to ensure that risk assessments were being completed fully in some cases. Statutory notifications to CQC, that are required by law, had improved but consistency in submitting these notifications was still not being sustainably achieved.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 22 October 2021).
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
Why we inspected
We undertook a targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about notifications not being made in good time and a recent death of someone in their own home due to a fire. A decision was made for us to inspect and examine those risks.
We inspected and found there was a concern with risk assessments not evidencing that all common potential risks were considered in most cases. Information held by the service was held on different sites and not readily accessible when requested. For these reasons we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.
You can see what action we have asked the provider to take at the end of this full report.
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 one breach of regulation in relation to safe care and treatment (regulation 12) and have made a recommendation in respect of achieving consistent and sustainable improvement to making statutory notifications to CQC.
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 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.