This inspection took place on 5 and 6 April 2018 and was announced. We gave the provider 48 hours' notice to ensure that someone would be available throughout the inspection process to provide us with the necessary information.

Hopscotch Asian Women's Centre provides care services to people living in their own homes. The service specialises in supporting people from the Asian community. At the time of this inspection there were 55 people using the service. The service provided care to people between the ages of 18 to 65 years some of whom are living with dementia, physical disabilities, learning disabilities and mental health conditions.

At the time of our inspection, the service did not have a registered manager in post. The previous registered manager left in February 2018. 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 service had recruited a new manager who was in post since February 2018. They told us they were in the process of applying to be formally registered with Care Quality Commission.

At our last inspection on 14 March 2017 we identified one breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider had not ensured that staff received appropriate training and professional development as was necessary to enable them to carry out the duties they were employed to perform. At this inspection we found this issue had been addressed. We saw that staff had received appropriate training or were scheduled to have training in the near future. Because many staff had a limited level of spoken and written English, an interpreting service had been provided to help staff to better understand and learn the training context. Staff received regular supervisions and appraisals to help them to carry out their professional duties.

From April 2018, the service had entered a new contract with the local authority for providing additional hours of care and support to people wider than the Asian community, which includes all different cultures and backgrounds. This meant the number of people receiving support from the service would significantly increase. During this inspection we found a number of shortfalls in the service delivery. Prompt improvements were needed to ensure the service was fully equipped to provide safe and effective support to people who used it. The main areas of improvement needed were related to medicines management, assessment of risk to health and wellbeing of people who used the service, dealing with complaints, meeting people’s nutritional needs, keeping robust records on care provided to people and analysing and taking actions following people’s feedback on care provided.

We found that the new manager and the service’s director were committed to implementing changes and introducing improvements to the service. A number of improvements had begun prior to our visit and was related to staff allocation, training and supervision. Since our inspection, they also provided evidence about further developments commenced at the service and which were triggered by feedback provided by us during our visit.

At this inspection we found the service had not managed people’s medicines safely and there was risk that people would not receive their medicines as required. There was no up to date information on what medicines had been prescribed to people and medicines administration had not been recorded systematically. Although staff had received appropriate training, staff competencies in medicine management had not been assessed.

We found that risk to health and wellbeing of people who used the service had not always been fully assessed and staff were not always provi

We carried out this inspection on 14 March 2017. We gave the provider 48 hours’ notice to ensure that someone would be available throughout the inspection process to provide us with the necessary information.

At our last inspection on 18 February 2016 we found that the provider was not meeting all the standards that we inspected. We identified breaches of Regulations 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service did not have appropriate systems in place to asses, monitor and improve the quality of the services provided. Staff did not receive appropriate support, training, professional development, supervision and appraisal as was necessary to enable them to carry out their role effectively. At this inspection we found that the provider had only partly addressed these concerns.

Hopscotch Asian Women’s Centre provides care services to people living in their own homes. The service specialises in supporting people from the Asian community. At the time of this inspection there were 56 people using the service. The service provides care to people between the ages of 18 to 65 years some of whom are living with dementia, physical disabilities, learning disabilities and mental health conditions.

A registered manager was in post at the time of the inspection. 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.

At the last inspection the provider had not provided staff with appropriate and adequate training in order for them to carry out their role effectively. During this inspection we found that although some improvements had been made the service had still not fully addressed this issue. Where staff were providing care to people with specific specialist needs, they had not been provided with the relevant training required in order to deliver safe and effective care.

Staff told us that they felt supported in their role and received regular supervision as well as an annual appraisal.

Feedback received from people and relatives was positive. People and relatives were happy with the care and support that they received from care staff especially taking into consideration that they were able to speak and communicate with each other in their preferred choice of language which was predominately Bengali.

The service carried out assessments of people’s needs and requirements prior to a package of care commencing. The assessment noted people’s needs and requirements, choices and wishes. It also identified all risks associated with the person’s care and health needs. However, although all risks had been identified, for certain specific risks associated with epilepsy, brain injuries or behaviour that challenges, there was no further information or guidance provided to staff in order to mitigate or reduce the risks to ensure people’s safety.

People and relatives told us that they felt safe in the presence of the care staff that supported them. All staff that we spoke with demonstrated a good understanding of safeguarding, what it meant and the actions they would take if abuse was suspected.

Safe medicine management processes were in place to ensure that people were supported safely with their medicines, where this support had been identified.

The provider had robust recruitment processes in place to ensure that staff who were employed were safe to work with vulnerable adults.

Rotas were managed appropriately ensuring that travel time was incorporated between each call. People and relatives confirmed that staff generally always arrived on time and spent the allotted time of the call. Where staff were running late the service ensured that people and relatives were called informing them of staff runni

We carried out an announced inspection on 18 February 2016. Hopscotch Asian Women's Centre provides personal care to people in their own homes in Camden. Currently there are 38 people, some older and some younger adults, who receive personal care from the agency.

A registered manager was in place at the time of the inspection. 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.

Staff were not always appropriately trained and the service could not demonstrate that staff were competent and skilled to support people safely. The training matrix showed how less than half of care workers employed had received medicines training and it was later confirmed that only three out of seventeen staff trained to support people with medicines had received refresher training.

Staff had received induction training; Only 19 out of 47 staff had completed mandatory dementia training. Staff did not always receive supervision and appraisal on a regular basis. Staff had not received adequate training and support to enable them to carry out the duties they were employed to do.

Spot checks on staff to check their competence and performance around service delivery were not carried out on any consistent basis. Although there was a service user survey carried out in 2015, the response was very poor with only five people returning their forms. The service was not able to determine the quality of the experience for people who used the service .There was evidence that people were asked for their views on the service provision via telephone interviews. The service was unable to demonstrate how issues raised were followed up with the relevant member of staff or any action taken. Audits of staff records or care records to ensure the quality of the care being provided was of a good standard were not carried out.

People were concerned that issues around staff being sent to them who were unfamiliar with their care were not responded to effectively. Staff sometimes did not stay for the allotted time. We made a recommendation that robust systems should be put in place to respond to concerns and issues in a timely manner to ensure the satisfaction of people using the service and their relatives.

Assessments were undertaken to assess any risks to the person using the service and to the staff supporting them. This included environmental risks and any risks due to the health and support needs of the person.

There were sufficient numbers of staff available to keep people safe. Care workers told us they had sufficient time in which to complete their visits and their schedule included travelling time between clients.

Thorough recruitment checks were carried out before staff started working at the service. We looked at staff records and saw how there was a safe and robust recruitment process in place.

Staff prompted people to take there medicines from blister packs. They recorded this on a Medicine Administration Record (MAR) in line with providers policy and procedures.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and how to support people who lacked the mental capacity in line with the principles of the act and particularly around decision making.

Some people were supported by staff with eating and drinking and this was detailed in people’s care plans. People were supported to access GP appointments as well as access to other health services to ensure they were able to maintain good health.

People and their relatives told us they were involved in developing their care and support plan and identifying what support they required from the service and how this was to be carried out.

We saw that people’s records included a person