Background to this inspection
Updated
30 June 2021
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 Care Act 2014.
Inspection team
This 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 and flats.
Notice of inspection
This inspection was announced. We gave the service over 48 hours’ notice of the inspection. The purpose of giving notice is because we needed to be sure that the provider who is also the registered manager would be in the office to support the inspection. However, the provider was not available for the inspection for 20 days following our announcement. The provider was abroad and was covering matters remotely. Even then when we did complete our office visit the provider was still abroad thereby limited our ability to check information.
What we did before the inspection
We reviewed information we had received about the service since the last inspection This included notifications of any safeguarding concerns or other incidents affecting the safety and wellbeing of people. We spoke with five people and had email contact with one person who received care from the service. We also spoke with one person’s relative. We also spoke with five care staff. We used all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
During the inspection we reviewed five people's care records which included care plans and risk assessments. We also looked at five staff files in relation to recruitment and staff supervision.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, medication administration records (MARs), policies and quality assurance records.
Updated
30 June 2021
About the service
Islington – London (also known as Blue Popies Care and Support Services) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults as well as people with physical and mental health conditions. At the time of this inspection, the service supported 22 people. Not everyone who used the service 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. At the time of our inspection there were 12 people using the service receiving the regulated activity of personal care.
The service is owned and managed by Mrs Kalliopi-Popi Galani. There is no requirement for a separate registered manager for this location. For the purposes of this report, we will refer to the 'provider' when speaking about the owner/manager of the service.
People’s experience of using this service and what we found
People who received care from the service told us they were well supported by care workers. People told us they felt safe when in the presence of care workers. Systems were in place to safeguard people from the risk of possible harm. Staff we spoke with understood their responsibilities with regards to safeguarding people. The service had safe recruitment procedures in place.
Medicines were being managed safely. However, we found some improvement was needed in relation to record keeping. Records indicated that staff had received training on the administration of medicines.
Appropriate risk assessments were in place and covered areas such as the environment, physical health and personal care.
When we gave the provider notice of the inspection, she informed us that she was abroad. Although we were able to start some aspects of the inspection, the provider was not available for the site visit part of the inspection for 20 days following our announcement. The arrangements in place whilst the provider was away were not suitable and limited our ability to check information.
There were some instances where the service failed to effectively check various aspects of the service and we found a continued breach of regulation. Together with the fact that the provider’s cover arrangements were of limited efficiency we judged that there was overall poor governance at this service.
Positive relationships had been developed between care workers and people they supported. People told us calls to their home were never missed and that care workers usually arrived on time. Consistency was an important aspect of the care provided. People told us they received care and support from the same care workers.
Accidents and incidents were documented. However, we noted that these lacked information about lessons learnt following an accident or incident.
Care workers we spoke with told us that they felt supported by the provider. They told us that management were approachable and they raised no concerns in respect of this. Staff had completed training relevant to their role.
People were supported to maintain good health and access healthcare services when needed. People were supported with their nutritional and hydration needs.
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. Care plans lacked information about people's level of capacity and we have made a recommendation in relation to this.
Procedures were in place to respond to complaints.
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 requires improvement (published 11 February 2020). The service remains rated requires improvement. This service has been rated as requires improvement for the last three consecutive inspections.
Why we inspected
The inspection was prompted in part by notification of a specific incident. Following which a person using the service died. The information CQC received about the incident indicated concerns about care provision. This inspection examined those risks.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.