About the service:

Barking Enterprise Centre provides personal care to people who live in their own homes. The service's office is based in Barking and Dagenham, London. At the time of our inspection, 68 people used the service and there were 36 staff.

People's experience of using this service:

¿ Although the service had enough staff to provide care, staff did not always arrive and leave on time. We asked the registered manager to make improvements on this. However, we found the service had made improvements since our previous inspection and was providing more safe and effective care.

¿ The staff recruitment process was robust ensuring that staff were properly checked and were provided with induction, training, supervision and support to deliver safe care.

¿ People's needs were assessed before they started receiving care. The registered manager was confident that the service could meet the needs of people using the service.

¿ Adult safeguarding protocols were in place and staff had knowledge and experience to follow correct procedures to identify, record and report concerns of abuse.

¿ Risk assessments were completed and reviewed for people. Staff were given guidance on how to mitigate risks to people.

¿ People and their relatives were involved in care plan reviews.

¿ Staff ensured that people's privacy, dignity and choice were respected. People were encouraged to be independent and to make decisions about their care.

¿ Staff had a good understanding of equality and diversity.

¿ Medicines were managed well. Where people needed support, staff administered medicines and kept records.

¿ Staff knew how to reduce the risk of infections. They had access to personal protective equipment such as gloves, shoe covers and aprons.

¿ Staff supported people to access health professionals and emergency medical services, when needed.

¿ Where required, staff supported people with meals of their preference.

¿ There was a clear management structure and people and relatives spoke positively about the registered manager.

¿ The quality of the service was regularly monitored, and the registered manager encouraged people and relatives to share their views about the care provided.

¿ The service worked with care professionals to plan and deliver an effective service.

¿ The registered manager took complaints seriously. This ensured that all complaints were investigated and responded to.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

¿ At the last inspection on 14 February 2018, (report published on 25, April 2018), the service was rated 'Requires Improvement'.

¿ At this inspection, the rating for the service improved to 'Good'.

Why we inspected:

¿ This was a planned inspection based on their previous inspection rating. We found the service met the characteristics of Good in four areas.

Follow up:

¿ We will continue to monitor intelligence we receive about the service until we return to visit as per our reinspection programme. If any concerning information is received, we may inspect sooner.

This comprehensive inspection took place on 14 February 2018 and was announced.

Barking Enterprise Centre (Reline Care Ltd) is based in the London Borough of Barking and Dagenham. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults.

Not everyone using Reline Care receives regulated activity; the CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Our last inspection report for this service was published on 26 May 2017 and we rated the service as ‘Inadequate.’ This was because we found breaches to Health and Social Care Regulations in relation to safeguarding people from abuse, receiving consent to care from people, recruiting fit and proper persons, providing person centred care, providing safe care and treatment, supporting staff and the overall governance and management of the service. In addition, the provider had also breached conditions of their registration to notify the CQC of serious incidents.

We placed the service in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection, the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

At the time of our latest inspection, 59 people were using the service, who received personal care. The provider employed 36 care staff, who supported people with personal care living in the local community.

The registered manager was committed to improving the service and had demonstrated the work they had carried out since the last inspection. We saw that improvements had been made in ensuring people were safeguarded and protected from abuse; staff, who were fit and proper persons, were recruited appropriately; staff were provided with training and were supported in their roles; people were provided with person centred care and their consent to care was sought, in accordance with the Mental Capacity Act 2005. The provider also notified us of serious incidents and safeguarding concerns.

However, despite the improvements, we found there were still some on-going issues because people were not always provided with safe care at the times that they had been assessed for as some people's visits by care staff were late or were missed. This placed people at risk of neglect because staff were not being deployed effectively to meet people's needs at the assessed times. Care staff did not always follow procedures to provide safe care when transferring and moving people. This meant people were at risk of harm or injury.

Complaints about the service were responded to appropriately and in a timely manner. However, some people we spoke with did not feel they had access to the necessary information to help them make a complaint. This meant that there was not an accessible system for identifying complaints to help further improve the service.

Staff had received an induction and training to ensure the service they provided to people was effective. They were able to shadow experienced staff in order for them to carry out their roles effectively. However, staff gave us mixed responses about the length of their induction and we recommend the provider looks into this.

Therefore, the provider's quality assurance systems and processes were not always effective in identifying all shortfalls in the service to assess, monitor and improve the quality and safety of the service. Therefore, we have now rated the service ‘Requires Improvement’.

The service had a registered manager in post. A registered manager is a person who has registered with

The service was inspected on 1, 2 and 5 December 2016. The inspection was announced. The provider was given 48 hours’ notice as they are a domiciliary care service and we needed to be sure staff would be available to speak with us. The service was last inspected in September 2014 when it was compliant with the outcomes inspected.

Barking Enterprise Centre is a large domiciliary care service providing personal care to people in their own homes. At the time of our inspection they were providing care to 155 people, most of whom were older adults.

The service had a registered manager in post. 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.

The service was not protecting people from abuse and neglect as incidents were not correctly identified as safeguarding issues or referred onto the local safeguarding authorities.

Risks to people were not appropriately mitigated. The measures in place to reduce risks were not robust and did not tell staff have to ensure people were safe.

Medicines were not managed in a safe way. Records were unclear and staff did not have sufficient information to ensure they supported people to take their medicines as prescribed.

People told us the service did not have enough staff and this led to them missing care visits or their care visits being late. The service was not following its recruitment policy and discrepancies in information provided by applicants were not explored.

The training provided to staff was not effective and staff did not have the knowledge they required to perform their roles.

Most people provided consent to their care and treatment in line with legislation and guidance. However, the provider did not follow the appropriate legislation and guidance, or maintain appropriate records, when providing care to people who lacked capacity to consent to their care.

People told us they did not consistently receive the support they needed with eating and drinking. Care plans did not contain details of people’s dietary needs and preferences.

Care plans were task focussed and did not contain information about people’s preferences, or how their religious and cultural background or sexuality affected their preferences for care. We have made a recommendation about ensuring care plans reflect people’s religion, culture and sexual identity.

Records of care showed that people were not consistently receiving care in line with their needs and preferences.

Management audits were ineffective as they had not identified issues with the quality of care plans, risk assessments or records of care. Although individual concerns had been addressed lessons learnt had not been applied to the whole service.

The service was not submitting notification to CQC as required.

People and staff gave us mixed feedback about the approachability and availability of the registered manager. Some people and staff found her open and approachable, others told us she was difficult to get in contact with and did not listen to feedback.

The service completed regular monitoring and collected feedback from people about their views on the service. The service had a robust complaints policy and records showed that complaints were responded to in line with the policy.

People told us some care staff displayed a caring attitude and treated them with dignity and respect. People told us other care staff were not caring.

We found breaches of eight regulations. You can see what action we told the provider to take at the back of the full version of this report.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures.’

Services in special measures will be kept under review and, if we have not taken im

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People’s care and support needs had been fully assessed. Potential risks to people had been identified and were acted upon by staff so that people were kept safe. Staff had access to guidance through an adult safeguarding policy and they understood their roles in relation to the protection of vulnerable adults. People were protected from the risk of harm because the provider had ensured staff knew how to recognise and report concerns about abuse or neglect.

We saw the service carried out criminal record checks on all staff who worked in the service to ensure they were suitable to work in the care sector.

People were supported by staff who had the knowledge and skills to deal with foreseeable emergencies. They had received first aid training which was regularly updated. Staff were provided with personal alarms that they could use when working alone.

Is the service effective?

People’s social, health and support needs were assessed with them, and they were involved in reviewing their care plans at least every six months. People told us the service met their identified needs. One person we spoke with said, “Staff do what I tell them to do, it’s a wonderful service.” Staff were able to explain how the Mental Capacity Act 2005. People told us staff always involved them in reviews of their care packages and changes were only made with their consent.

Is the service caring?

People were supported by kind and attentive staff. Staff were able to explain how they supported people to maintain their dignity and deliver services in a caring way. Care plans included details of how people liked to be supported. People told us that staff were caring. One person said, “The staff are very thoughtful, I am very satisfied with them.”

Is the service responsive?

We saw that the service had a system in place to respond to complaints and comments. The service had asked people’s view of the service and responded to what people told them. Records showed that people needs were assessed before they signed agreements to receive the service.

Is the service well-led?

Staff were clear about the aims and objectives of the service. Quality assurance processes were in place to check what people thought about the service. We saw the service had sent feedback forms to people who used the service and their relatives. The service took account of what people told them in the feedback forms.