Archived: Sanctuary Home Care Ltd - Tower Hamlets

Sanctuary Home Care Ltd – Tower Hamlets is a domiciliary care agency which provides personal care and support to people in their own homes. At the time of our visit the service was providing personal care and support to 237 people in the London Borough of Tower Hamlets. All of the people using the service were funded by the local authority.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People who lived with specific health conditions did not always have the risks associated with these conditions assessed and care plans were not always developed from these to ensure their safety and welfare. Actions to manage risk that were recorded in risk assessments were not followed.

People received their medicines by staff who had received relevant medicines training however, information within people’s records was not always up to date and a number of issues were found with the recording of medicines and unexplained gaps. We could not always be assured that people received their medicines safely.

The provider had a robust staff recruitment process and the provider completed the necessary checks to ensure staff were suitable to work with people using the service.

The provider had a good understanding of the policies and procedures in place to safeguard people from abuse and avoidable harm. Incidents were reported and followed up and we saw evidence that disciplinary procedures were followed.

Staff had an awareness of the principles of the Mental Capacity Act 2005 (MCA) and care workers respected people’s decisions and gained people’s consent before they provided personal care. However, the service did not always ensure that where appropriate, representatives had legal authority to sign people’s care plans to agree with the care to be provided.

Care workers received an induction training programme to support them in meeting people’s needs effectively and were introduced to people before starting work with them. They shadowed more experienced staff before they started to deliver personal care independently. Staff received regular supervision and told us they felt supported and were happy with the supervision they received.

We saw people were supported to maintain their health and well-being through access to health and social care professionals, such as GPs and social services. Issues that occurred were followed up with the relevant health and social care professionals.

People were supported to have sufficient food and drink and care records were detailed with regards to people’s preferred food however care plans did not always identify nutritional risks or needs.

People told us that staff respected their privacy and dignity and promoted their independence. There was evidence that language and cultural requirements were considered when carrying out the assessments and allocating care workers to people using the service.

People and their relatives told us that their regular care workers were kind and caring, gave them choices and knew how to support them.

An initial assessment was completed from which care plans and risk assessments were developed. Care was designed to meet people’s individual needs and was reviewed if there were any significant changes. However they did not always accurately reflect the care people received.

People and their relatives knew how to make a complaint and were able to share their views and opinions about the service they received. There were quality monitoring visits and phone calls in place to allow people and their relatives the opportunity to feedback about the care and treatment they received.

The registered manager told us that the service promoted an open and honest culture. Some staff felt well supported by the management team and were confident they could raise any concerns or issues, knowing they would be listened to and acted upon. However, other members of staff felt discriminated against. There were also morale issues due to the current uncertainty regarding the future of the service.

Quality assurance and management systems were in place to monitor the service however they were not always consistent as they did not pick up all the issues we found during the inspection.

We found three breaches of regulations relating to consent, assessing and managing risks and the safe management of medicines. You can see what action we told the provider to take at the end of the full version of this report

People were happy with their care and told us their care workers usually arrived on time and were caring and friendly. People felt safe with their care workers and knew who to contact if they had any concerns. We observed staff interacting with people positively and respecting people's religious and cultural needs, independence and privacy. We reviewed a number of care plans which included clear information about people's assessed need and any risks. The provider shared information with other agencies appropriately.

We spoke with six care workers with varying levels of experience and five managers. The staff told us they had good support from their managers and were able to access training. Most staff were positive about working for Sanctuary Care. We saw evidence that the provider monitored the quality of the service by carrying out spot checks of care, auditing records, investigating complaints and incidents and obtaining feedback from people using the service and their relatives.