This inspection took place on 22 and 23 March 2017 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service; we needed to be sure that someone would be in. This was the first inspection of the provider since it had registered at a different address with the Care Quality Commission (CQC).HomeInstead Senior Care, Wandsworth, Lambeth & Dulwich provides personal care for people in their own homes. The office is based in the Earlsfield area but provides care to people in Wandsworth, Lambeth and Dulwich. At the time of the inspection there were approximately 80 people using the service.
There was a registered manager at the service. 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.
Care workers were known within the organisation as 'caregivers,' we have called them this in the report.
People and their relatives praised the caregivers for their empathy and were pleased with how they were supported. The minimum length of calls the provider offered was one hour, regardless of the level of support needed. This meant that caregivers were given time to complete their tasks but also to offer companionship to people which in turn allowed for caring relationships to develop.
Care plans were written in a person-centred manner and were easy to read. They contained information about people’s background, their working and family life and other information. Caregivers were familiar with people, their support needs but also their personality, their life and the things they enjoyed.
We found there were enough caregivers employed to meet people’s needs. The provider tried to ensure a team of caregivers were allocated to each person, which helped to provide continuity of care and familiarity if caregivers were away on leave.
Although there were recruitment checks in place which helped to ensure caregivers were safe to work with people, we found that not all references we saw were verified for their authenticity.
Caregivers completed an induction programme which was based on the Care Certificate, thereafter they received regular training and supervision.
An initial assessment was completed in people’s homes before they started to use the service, this included risk assessments in relation to physical needs, moving and handling and the environment. Person centred care plans were developed using the information gathered during the initial assessment. People were given time to decide whether they wanted to be supported by the provider and consent was sought before care was started.
Supervisors reviewed care plans at regular intervals which helped to ensure they were up to date. They also carried out client audit reports and service reviews which helped to ensure records were being completed correctly and people and their relatives were happy with the service provided.
People and their relatives were given an information pack which included details about the providers’ complaints policy and how they could raise concerns if they were not happy with any aspect of the service.
Although people and their relatives told us they were supported appropriately with respect to their medicines, we found there was inconsistency in some of the records we saw in relation to the level of medicines support that was provided.
We received positive feedback about the management of the service. People and their relatives told us that they could always contact someone and they were kept up to date about any changes. Care plans were reviewed regularly and people were asked for their feedback about the service by independent external companies. The registered manager was active in the community, working with community organisations, raising awareness about dementia.
We have made two recommendations in relation to medicines management and staff recruitment.