Background to this inspection
Updated
15 October 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 15 September 2015 and was announced. The provider was given 48 hours’ notice because the location provides a small domiciliary care service and we wanted to make sure people were available.
The inspection team included one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience on this inspection had personal experience of caring for someone who had a learning disability.
Before the inspection we looked at all the information we had about the provider including notifications of significant events. We spoke with representatives of the London Borough of Hillingdon who commissioned the service. We received copies of reports from the London Borough of Hillingdon regarding their own audits of the service.
People who used the service were not able to tell us about their experience of the service because of the degree of their learning disability. We spoke with the relatives and representatives for six of the people who were using the service over the telephone. We also spoke with six members of staff on the telephone.
During the inspection visit we met two people who were using the service, three support workers, a team leader and the manager. We looked at the records relating to the care and support of two people, the records of staff recruitment and support for six members of staff, record of the provider’s checks on the service, staff communication, records of incidents and accidents and how medicines were being managed for two people.
Updated
15 October 2015
The inspection took place on 15 September and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service at an office location and at supported living services.
This was the first inspection of the service which was registered in April 2015.
Enable UK (Midlands) Limited is a private organisation. This branch of the organisation provides personal care and support to adults who have a learning disability living in the London Borough of Hillingdon. At the time of our inspection they provided support to eight men who lived in three different homes.
The provider had a registered office location which we visited. We also visited one location where four people lived as part of our inspection.
There was not a registered manager in post. The manager of the service had applied to be registered the Care Quality Commission. 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 and associated Regulations about how the service is run.
The recruitment procedures for staff did not always include making checks on their criminal record or obtaining references from previous employers.
Relatives of people using the service felt that the staff were not always deployed in a way to best meet their needs and sometimes the staff worked long shifts on consecutive days.
The staff did not have the support, training and supervision they needed to care for and support people.
The provider did not always respond and take appropriate action when people complained about the service. People did not always feel well informed or involved.
The relatives of people who used the service and staff did not feel the service was well managed or led. They told us they were not able to get the information and support they needed. They were concerned about changes in management and the lack of managerial support for the services.
The provider did not operate an effective system to monitor, assess and improve the quality of the service.
There were risk management and support plans for each person which identified where they might be at risk and what the staff needed to do to support them.
People were supported to have the right medicines and these were stored and recorded appropriately.
People’s capacity to make decisions had been assessed and where they lacked capacity, other relevant people made decisions in their best interest and these were recorded.
People’s nutritional needs were met and they had a choice and variety of meals. However, relatives were concerned that people did not always receive freshly prepared food and did not always have enough fruit and vegetables.
People were supported to meet their health care needs. The staff were kind, caring and polite. People’s privacy and dignity was respected. The staff and the people who they were caring for had positive relationships with each other.
Each person had a clear and up to date support plan which described their needs and the support they required from the staff. Relatives of people who used the service felt that some of their needs were not being fully met.
You can see what action we told the provider to take at the back of the full version of the report.