25 October 2022
During a routine inspection
At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
About the service
Johnston’s Homecare Ltd is a domiciliary care agency providing personal care and support to people living in their own homes. People’s needs were varied and included older people and people who had physical disabilities. At the time of the inspection, 21 people living in the north of London were using the service, out of whom, 17 people 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.
People’s experience of using this service and what we found
Right Support:
While people received care from a consistent staff team, staff were not always recruited safely. We found issues with recruitment checks and staffing arrangements.
The service assessed risks to people’s health, care and welfare. However, there were discrepancies in risk assessments as not every risk was carefully assessed to ensure people received safe care and support.
Staff offered people choices and sought their views when providing care. Staff treated people with dignity while promoting their independence.
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.
Right Care:
People were safeguarded from abuse and staff were fully aware of their duties to report concerns. People received their medicines safely and as prescribed. There were infection prevention and control measures in place to protect people from the risk of the spread of infection.
People received a comprehensive assessment of their needs before they received care. People had access to healthcare when needed. Staff had clear guidance on supporting people to eat and drink as per their wishes.
People received person-centred care and support from a caring and respectful staff team. Staff received appropriate support to be able to perform their roles and provided good care to people.
Staff promoted equality and diversity in their support for people. They understood people's cultural needs and provided culturally appropriate care.
Right Culture:
Management oversight did not prove to be effective and quality assurance procedures were not robust enough as although some of the issues we found at this inspection had been identified, they had not been addressed in a timely manner.
The service had a system to manage complaints. People, their relatives and staff felt safe to raise concerns and share their views to the management. The provider worked in collaboration with other agencies to ensure people received appropriate and personalised care and support.
People and those important to them were involved in planning their care. People and their relatives were satisfied with the support they received from the management.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This was the first inspection of this service. The service was registered with us on 18 December 2020 but did not provide a regulated activity until May 2022.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We have identified a breach in relation to fit and proper persons employed at this inspection.
We made recommendations about staff deployment and assessing risks to people’s health, care and welfare.
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 quality and 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.