About the service:

SW Homecare Agency is a domiciliary care agency which provides care to people in their own homes. There were five people using the service at the time of our inspection. They were all adults (over 65 years of age), Everyone using the service lived within the London Borough of Harrow and had their service commissioned by the local authority. The service provided covered a range of areas including personal care, housework and laundry.

People’s experience of using this service:

The service was not always well-led. Quality audits were not effective as they had failed to identify the issues we have highlighted in this report. The audits that the service had carried out had not identified these issues.

People did not always receive personalised care. Their needs had been assessed by the service prior to receiving services. However, the care plans provided insufficient detail to give care workers the information they needed to provide personalised care and support that was consistent and responsive to people's individual needs.

There were systems and processes in place to minimise risks to people. However, we saw that in some files no risk assessments had been completed or updated. This meant care workers did not always have specific information regarding risks and methods of mitigating them.

The requirements of the Mental Capacity Act (MCA) 2005 were not always met. We found that capacity assessments were generalised to all decisions and not developed in relation to specific decisions as required by the MCA. We recommended that they sought guidance in relation to the development of capacity assessments in relation to specific conditions.

People told us that they felt safe receiving care from the care workers. There were safeguarding systems and processes to support care workers to understand their role and responsibilities to protect people from avoidable harm. Relevant policies were in place.

Safe recruitment procedures were now in place. This ensured all pre-employment requirements were completed before new staff were appointed and commenced their employment.

People were involved in making decisions about their care and support. People or where necessary, their relatives had signed their plans to show that they consented to the care provided by the service.

People, relatives and staff spoke positively about the registered manager and felt able to raise concerns and were confident that these would be addressed.

Care workers had received a range of training and support to enable them to carry out their role safely. People told us they received the right care and support from care workers who were well trained and competent at what they did.

People were very positive about the staff and told us that their privacy and dignity was promoted.

More information is in the full report.

We identified three breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to good governance. Details of action we have asked the provider to take can be found at the end of this report.

Rating at last inspection:

At our last inspection, the service was rated "Good". Our last report was published on 25 August 2016.

Follow up:

We have asked the provider to send us an action plan telling us what steps they are to take to make the improvements needed. We will continue to monitor information and intelligence we receive about the service to ensure good quality is provided to people. We will return to re-inspect in line with our inspection timescales for Requires Improvement services.

SW Homecare provides domiciliary care and support to four older people living in their own homes in Harrow and surrounding area.

The service had 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 200 and associated Regulations about how the service is run.’

People told us they felt safe with the support they received from care staff. There were arrangements in place to help safeguard people from the risk of abuse. The service had appropriate policies and procedures in place to inform people who used the service and staff how to report potential or suspected abuse. Care staff understood what constituted abuse and were aware of the steps to take to protect people.

People had risk assessments and risk management plans to reduce the likelihood of harm. The service ensured there were safe recruitment procedures in place to help protect people from the risks of being cared for by staff assessed to be unfit or unsuitable.

Care staff told us and we saw from their records that they had received training in relevant areas of their work. This training enabled staff to support people effectively.

Care staff understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA). People told us and we saw from their records they were involved in making decisions about their care and support and their consent was sought and documented.

People were supported with their meals. Their care plans included an assessment of their nutrition and hydration needs. People told us they chose what they ate and staff supported them with meals.

People told us they were treated with dignity and respect. Care staff understood the need to protect people’s privacy and dignity. People told us staff knocked on their doors before they could enter their homes.

The service encouraged people to raise any concerns. At the time of this inspection, the service had not received any complaints.

Staff gave positive feedback about the management of the service. The registered manager was approachable and fully engaged with providing good quality care for people who used the service. They encouraged a positive and open culture by being supportive to staff and by making themselves approachable.

The provider had systems in place to continually monitor the quality of the service and people were asked for their opinions. Action plans were developed where required to address areas for improvements.