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Archived: Scope Inclusion North London

Overall: Requires improvement read more about inspection ratings

6 Market Road, London, N7 9PW (020) 7619 7149

Provided and run by:
Scope

All Inspections

10 September 2015

During a routine inspection

We carried out an announced inspection on the 10 September 2015. The last inspection of this service was carried out on 14 May 2014 and all the regulations we inspected were met.

Scope Inclusion North London provides personal care and befriending support for children and adults with learning disabilities, physical disabilities and sensory impairment. Forty two children living in their own homes and three adults were being supported in a shared house at the time of our visit.

The service had 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.

We could not always evidence that training identified for staff was completed. Staff training records did not always reflect the training that staff had undertaken with other organisation.

Support staff did not always receive regular supervision and appraisal from senior staff or the registered manager.

We could not evidence that effective systems were in place to ensure spot checks on staff practice were being conducted regularly.

You can see what action we told the provider to take at the back of the full version of the report.

There were detailed generic risk assessments in place; however the generic risk assessments could make the person less safe if a care worker followed them instead of a more person specific assessment.

We recommend that, where appropriate, risk assessments are personalised to ensure that they meet people’s needs.

There were suitable arrangements in place to safeguard adults and children including procedures to follow and how to report and record information.

There were sufficient numbers of suitable staff to meet people’s needs and keep them safe.

Medicines were administered appropriately in line with medicine policies and procedures.

Staff had a good understanding of the Mental Capacity Act 2005 and knew how to support people using the principles of the Act.

People were supported to maintain a balanced diet and their requirements were detailed in their support plans.

Staff respected people’s wishes and encouraged people to be as independent as possible. They understood how to support people with regards to equality and diversity.

Assessments were undertaken to identify people’s support needs and support plans were developed outlining how these needs were to be met.

There was good engagement with community health and social care professionals who confirmed that staff had a positive approach, provided regular feedback and assisted them in delivering appropriate support for people using the service.

14 May 2014

During a routine inspection

A single Inspector carried out this inspection. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what parents and guardians of children using the service and staff told us, what we observed and the records we looked at.

Is the service safe?

Children who used the service had comprehensive support plans outlining their support needs and guidelines for support staff to keep them safe. Staff received training to facilitate this, however both staff and families we spoke with told us they felt that support workers could benefit from additional training in responding to challenging behaviour and responding to crises.

Staff followed appropriate procedures to reduce the risk and spread of infection when providing personal care support to children.

Is the service effective?

Families of children who use the service we spoke with were very positive about the service provided. One parent told us "I am personally very happy, it is a very valuable service. I get a rest from my caring responsibilities and my child is supported to learn new skills and meet new friends". Another parent told us "The befriender is a gem - they have developed such a lovely bond with my child. I have no complaints".

However, one parent we spoke with highlighted an area in which they felt the support could improve. Their child had very high support needs and required frequent hospital stays, during which the support worker did not visit them, so they were not receiving the full support hours to which they were entitled.

The provider worked closely in cooperation with other services to ensure the support provided met children's needs.

Is the service caring?

The provider had engaged a consultant to introduce person-centred support tools for staff to use, and some of these had been implemented by the time of our visit. These ensured that children were given increased say in planning and delivery of their support. Families we spoke with told us they felt the staff were very caring in their approach, with several commenting on the bond and rapport their child had developed with the support worker.

Is the service responsive?

Several families we spoke with told us they valued the flexibility of the service and had requested changes to their child's support to better meet their needs. We found that complaints were handled appropriately and the service sought and responded to feedback.

Is the service well-led?

Support staff we spoke with told us that a stable management team, in place since October 2013, had made a great difference to how well the service was led. New systems had been introduced to improve the quality of the service that children and their families received, and to monitor and manage the work of the support staff.

29 November 2013

During an inspection looking at part of the service

When we last visited the service in July 2013, we found that children referred to the service were at risk of receiving unsafe or inappropriate care arising due to a lack of accurate and appropriate information in relation to their ongoing care and support.

While some anomalies with records remained, a new temporary member of staff employed from the end of October 2013, had taken steps to address the concerns we had highlighted. We saw that this person had visited children and their families, reviewed support plans and completed these support plans appropriately. A care coordinator who had moved to another role within the organisation had also carried out a review of some of these records after our visit in July.

When we visited in July 2013, we found that the provider had failed to implement their action plan that was created to address the non-compliance we had highlighted. We asked the provider for a further action plan after our visit in July. We did not receive this action plan.

When we visited this time, we found that the provider does not have effective systems in place to identify, assess and manage risks to the health, safety and welfare of children who use the service.

4 July 2013

During a routine inspection

We found that there was a new manager of the service who had commenced employment approximately five weeks before we visited. We also found that there was a new service coordinator who had commenced employment approximately eight weeks before we visited. We asked the new manager if they were going to apply to become the registered manager of the service and they confirmed that they would be applying in the near future. The provider might find it useful to note that there has been no registered manager in post at this service for over six months.

We found that children were typically supported by the service for two to four hours per week.

No support was provided children without the parent or guardian's consent. We found that children received continuity of care as they were supported by the same support worker each week.

Children supported by the service were protected from the risk of abuse and staff were supported to deliver care and support to an appropriate standard.

We found that the majority of records were appropriate and complete which we had not found during our last visit to the service in January 2013. However,we also found that several of the files had not been updated and that they still contained incomplete records. This meant that while the provider had taken steps to address the issues we highlighted with new records, they hadn't reviewed and updated the old files where we had identified the anomalies initially.

4 January 2013

During a routine inspection

At the time of our inspection the service was supporting 25 children. The registered manager had recently left the service and it was managed by an acting manager. We found that the provider had carried out a compliance review of the service and had drafted an action plan with the aim of improving the quality of care provided.

We spoke with three parents of six of the children who used the service. One parent told us that the support workers worked well with their children and had the right experience to meet their changing needs. Another parent told us that the two support workers who worked with their children were "exceptional, extraordinarily good" and they said "both support workers are beyond what we expected". Another parent told us that the staff were "a great bunch of people" and that they "highly value" the service.

Children's choices and independence were supported and support workers worked with children to improve their enjoyment of activities. Support workers knew children's likes and dislikes and were able to make sure that support was provided to meet these preferences. One parent told us that the support workers "understand what the children need".

We found that the provider had taken steps to make sure that children who used the service were protected from the risks of abuse.

We found that their was a risk to children who used the service of inappropriate care due to a lack of complete and accurate information to support the delivery of care.