Archived: Westminster Homecare Limited (Crystal Palace)

Updated 14 December 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Before the inspection, we looked at all the information we had about the service. This information included statutory notifications that the provider had sent to CQC. A notification is information about important events, which the service is required to send us by law. We spoke with the local authorities that commission the service to obtain their views. We received concerns in relation to people using the service receiving late calls.

This inspection took place on 12 and 13 October 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 the registered manager would be there. The inspection team consisted of one adult social care inspector who attended the office on both days of the inspection. Following the inspection four adult social inspectors carried out telephone interviews with people who used the service.

We spoke with 14 people who used the service, three relatives, eight members of staff, the registered manager, the operations support manager and the quality assurance officer. We reviewed records, including the care records of 10 people who used the service, ten staff members' recruitment files and training records. We also looked at records related to the management of the service such as quality audits, accident and incident records and policies and procedures.

Updated 14 December 2016

We carried out an announced responsive inspection of this service on 12 and 13 October 2016. This inspection was carried out after we received concerns in relation to people using the service receiving late calls. We told the provider two days before our visit that we would be coming, as we wanted to make sure the registered manager would be available. At the time of our inspection the registered manager told us the service was providing personal care to 253 people.

At our previous comprehensive inspection on 21 July 2014 we found the provider was meeting the regulations we inspected.

Westminster Homecare Limited (Crystal Palace) provides personal care for people in their own homes within the London boroughs of Bromley, Croydon, Lambeth and Wandsworth. There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission 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.

At this inspection we found breaches of legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Medicine Administration Records (MAR) were not always completed in full to demonstrate that medicines had been administered. Records we checked showed information missing from four people’s MAR charts and no reasons had been recorded to explain why people's medicine had not been administered correctly.

This is a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities Regulations 2014). You can see what action we told the provider to take in relation to the above breaches at the back of the full version of the report.

Staff were not regularly supported through regular supervisions and appraisals in order to identify any shortfalls in knowledge or training and address any issues so that people continued to receive appropriate standards of care.

This is a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities Regulations 2014). You can see what action we told the provider to take in relation to the above breaches at the back of the full version of the report.

Complaints were not investigated and handled in line with the provider’s policy.

This is a breach of regulation 16 of the Health and Social Care Act 2008 (Regulated Activities Regulations 2014).You can see what action we told the provider to take in relation to the above breaches at the back of the full version of the report.

Adequate systems were not in place to monitor the quality and safety of the service provided. The service failed to effectively operate the Electronic Call Monitoring (ECM) system for people living in their own homes in Lambeth in regards to missed and late calls. (The ECM system for Bromley was not available during the inspection due to technical issues). The service failed to have an effective system in place to monitor missed and late calls for people who were living in their own homes in

Croydon, and Wandsworth. The service failed to carry out internal audits to monitor the quality and safety of the service and identify shortfalls.

This is a breach found of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

There were enough staff but they were frequently late to deliver people’s care. This meant that people who used the service were not receiving the full call time booked.

People told us they felt safe. Safeguarding adult’s procedures were robust and staff understood how to safeguard the people they supported. There was a whistle-blowing procedure available and staff said they would use it if they needed to. The service had systems in place to manage accidents and incidents whilst trying to reduce reoccurrence.

The provider conducted appropriate recruitment checks before staff started work to ensure staff were suitable and fit to support people using the service.

There were processes in place to ensure staff new to the service, were inducted into the service appropriately. Staff training was up to date.

The manager and staff understood the Mental Capacity Act 2005 (MCA) and acted according to this legislation. People’s nutritional needs and preferences were met and people had access to health and social care professionals when required.

People were treated with kindness and compassion and people's privacy and dignity was respected. Staff encouraged people to be as independent as possible.

People were involved in their care planning and their care, support they received was personalised, and staff respected their wishes and met their needs. Care plans and risk assessments provided clear information for staff on how to support people using the service with their needs. Care plans were reflective of people's individual care needs and were reviewed on a regular basis. Peoples' care files were kept both in the person’s home and in the office.

Regular staff meetings were held and staff said they enjoyed working for the service and they received good support from the manager. There was an out of hours on call system in operation that ensured that management support and advice was always available to staff when they needed it. The provider took into account the views of people using the service.