North London Asian Care improved from Requires Improvement to Good overall following a focused inspection of Safe, Effective and Well-led domains, with the previous breach of Regulation 19 remedied. The main remaining concern is inadequate risk assessment and staff training for people with diabetes, leading to a continued Requires Improvement rating for Safe.
Concerns (6)
criticalCare planning: “One person's risk assessment and care plan did not contain important information about the risks associated with their diabetes nor details of who was responsible for administering their insulin”
moderateStaff training
: “Records showed staff had not been trained in managing diabetes. Many staff did not have up to date training on pressure ulcer awareness.”
moderateStaff competency: “The assessment of their competency in giving medicines was not recorded although we saw this was checked at spot checks of care workers carrying out their duties.”
moderateRecord keeping: “Some files contained details of the person's legal representative when they did not have one. For example, a relative was described as having lasting power of attorney in error.”
moderateConsent / capacity: “A relative was described as having lasting power of attorney in error...only people with legal authorisation were able to make decisions on behalf of a person.”
minorGovernance: “One staff did not have a reference from their last employer in care and this had not been picked up at interview or when their file was audited. Another worker had an unexplained gap in employment.”
Strengths
· Staff arrived on time and stayed for the agreed amount of time; people reported no missed calls or late visits.
· Service specialises in cultural and linguistic matching; most people had a care worker who spoke the same language.
· Low staff turnover supported consistent care from staff who knew people well.
· Mandatory training completed; induction included shadowing with experienced staff.
· Electronic call monitoring system enabled rapid response to late or missed visits.
Quality-Statement breakdown (14)
safe: Staffing and recruitmentGood
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Preventing and controlling infectionGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safely; Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people, continuous learning and improving careGood