We undertook an announced inspection of Aquaflo Care Barnet on 25 October 2017.

Aquaflo Care Barnet is a domiciliary care agency registered to provide personal care to people in their own homes. At the time of our inspection, the service told us that they were providing care to 53 people.

There was a registered manager in post. 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.

The last comprehensive inspection we carried out in October 2016 found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. During this inspection in October 2017, we found that the service had taken appropriate action to improve on the breaches of regulation we previously identified.

People and their relatives informed us that they were satisfied with the care and services provided by the service. People told us they felt safe around care staff and were treated with respect and dignity. Relatives of people who used the service said they were confident that people were safe around care staff and raised no concerns in respect of this.

Our previous inspection in October 2016 found that a significant proportion of risk assessments contained limited information and some areas of potential risks to people had not been identified and we found a breach of regulation in respect of this. During this inspection in October 2017, we found that the service had made improvements and new format risk assessments were in place for all people. We found that the majority of risks had been identified. However, we found that in some people’s care plans there was a lack of information about the action to take to reduce risks. Following the inspection, the registered manager sent us evidence to confirm that they had added necessary information in the risk assessments we discussed and said that they would ensure that this was done with all risk assessments.

There were processes in place to help ensure people were protected from the risk of abuse. Our previous inspection found that some care workers were unable to describe the process for identifying and reporting safeguarding concerns. During our inspection in October 2017, the registered manager confirmed that staff had received safeguarding refresher training since the inspection. Care workers we spoke with during this inspection were all aware of the process for identifying and reporting safeguarding concerns.

There were arrangements to manage medicines safely and appropriately. Records showed care workers had received medicines training as part of their induction and their level of competency was tested. Medicines policies and procedures were in place. Our previous inspection in October 2016 found unexplained gaps in some Medication Administration Records (MARs) and also found that these gaps were not identified by the service. During this inspection in October 2017, we found some gaps in MARs that we looked at. However, we noted that the service had a comprehensive audit system in place and had identified all of the gaps and taken action.

The service used an electronic system for monitoring care worker's timekeeping and whether they turned up on time or were late. We looked at a sample of people’s timekeeping records and found with one exception, care workers attended to people within 30 minutes of their allocated time. We noted that reviews of care and feedback indicated that punctuality was not a significant concern of people. The majority of people and relatives we spoke with told us that generally care workers were on time and they raised no concerns regarding this.

We looked at the recruitment process to see if the required checks had been carried out before staff started

We undertook an announced inspection of Aquaflo Care Barnet on 24 and 25 October 2016.

Aquaflo Care Barnet is a domiciliary care agency registered to provide personal care to people in their own homes in Barnet and Brent. At the time of our inspection, the service told us that they were providing care to 63 people.

There was a registered manager in post. 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.

Aquaflo Care Barnet was previously registered with the CQC under a different name and at a different address. Aquaflo Care Barnet re-registered with the CQC at the new location on 26 September 2016. This was the first inspection of the service.

People who used the service told us that they felt safe around care workers. They said they were treated with respect and dignity when being cared for by care workers. Relatives told us they were confident that people were safe when being cared for by care workers.

Individual risk assessments were completed for people. However, a significant proportion of assessments contained limited information and some areas of potential risks to people had not been identified and included in the risk assessments. This could result in people receiving unsafe care and we found a breach of regulations in respect of this.

There were processes in place to help ensure people were protected from the risk of abuse. Despite receiving safeguarding training as part of their induction, some care workers we spoke with were unable to describe the process for identifying and reporting concerns and were unable able to give example of types of abuse that may occur.

There were arrangements to manage medicines safely and appropriately. Records showed care workers had received medicines training as part of their induction. Medicines policies and procedures were in place. However, we found unexplained gaps in five out of the 10 people’s Medication Administration Records (MAR). Further, we found that MARs were not completed fully. People were therefore at risk of not receiving their medicines safely and we found a breach of regulation in respect of this.

The service used an electronic system for monitoring care worker's timekeeping and whether they turned up on time or were late. We looked at a sample of people’s timekeeping records and found that there were numerous instances of calls being made to people which were in excess of 30 minutes of the agreed time. The registered manager confirmed that in these cases, the issues with the current electronic system was the reason why the records indicated that there were late visits.

As a result of the above we spoke with some of the people whose call logs indicated that there were a number of late visits as well as other people and relatives about the punctuality of care workers. All people we spoke with told us that generally care workers were on time and they raised no concerns regarding this. We also asked people and relatives if there were any instances where care workers had failed to arrive for a scheduled visit. All people and relatives told us that care workers always arrived for their contracted visits and stayed for the duration of the time required. Where people required two care workers for a visit, we asked them whether two care workers attended their visits and they told us that they did.

We looked at the recruitment process to see if the required checks had been carried out before staff started working with people who used the service. We looked at the recruitment records for twenty members of staff and found background checks for safer recruitment including, enhanced criminal record checks had been undertaken and proof of their identity and right to