Archived: London Care (Brentford)

The inspection took place on 17 August 2015 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. The service was registered on 22 June 2015 and this was the first inspection of this location. However the service was previously managed from two different locations in Brentford and Wembley. The last inspection of the Wembley branch took place on 18 September and 3 October 2014. There was one breach of Regulation relating to records on staff suitability to work. The last inspection of the Brentford branch took place on 23 April 2014 and there were no breaches of Regulation.

At this inspection we found a number of breaches of Regulation.

London Care (Brentford) is a domiciliary care agency providing personal care and support to people who live in their own homes in Brentford and Wembley. At the time of our inspection approximately 150 people were using the service. The majority of people were over the age of 65 years old, although some younger adults with a learning disability also received support. The branch employed approximately 70 care workers. There was 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 and associated Regulations about how the service is run.

London Care (Brentford) was run by London Care, a private organisation who provided domiciliary care throughout London and the South east of England.

The care staff did not always receive supervision, support and appraisal of their work or the training they needed to carry out their role. Therefore people may have been at risk of receiving unsafe or inappropriate care.

People did not always receive care at a time which met their needs and preferences. Where people had requested changes to their care the provider had not always responded to these.

People were not always satisfied with the way in which the service was led. For example, when they had concerns they felt these were not always addressed and they were not always able to speak with a manager about these. People told us care staff were often late, did not have enough travel time between appointments and the agency did not tell them if care staff were running late or if their regular carer was not available.

The staff did not have regular supervision, training or appraisals. They did not feel supported and they were concerned that there had been a lot of changes in the senior staff team and management of the service.

The registered manager was working at the service on a temporary basis as her permanent job was managing another branch.

Some records had not been dated and the provider had not collected records of the care provided from people’s homes so they had not always checked that care was delivered as planned.

People felt safe and trusted the care staff. However some people were concerned that because the staff were often later than they expected for visits, this could mean they were at risk of being left without care, food or medicines.

The provider had procedures for safeguarding adults. They were raising awareness of these by discussing them with people using the service and their families. The staff had all received training in these, but longer serving staff had not had training updates and therefore may not have the most up to date knowledge of guidance and best practice.

The risks to people had been assessed and there were plans to minimise these. However, these assessments had not always been dated and therefore it was difficult to tell whether they reflected the person’s current needs.

People were happy with the support they received with their medicines. The staff were trained so they could safely support people with these.

The provider’s recruitment procedures included checks on staff suitability. The managers told us they were recruiting new staff and had a fair amount of staff turnover and changes making it a challenge to cover staff absences. However, they said they were able to care for everyone with the staffing levels they had. Some people said that there were not enough staff when their regular care staff were off sick and this meant they had to wait a long time for their care visits.

People had consented to their care and treatment.

People’s nutritional and healthcare needs were assessed and the staff liaised with other professionals to make sure these were met.

People told us they liked their regular carers. They said they were kind, caring and polite. People told us the staff treated them with dignity and respect.

People’s care needs were recorded and had been reviewed, and people were asked for their opinions as part of these reviews.

There was an appropriate complaints procedure and people felt complaints were responded to, although they said they did not always get a response to informal concerns.

The manager was working with the local authorities who commissioned the service to plan improvements. They had improved systems for collating feedback from people using the service and staff. They had created an action plan which outlined the concerns which they had identified and had plans to make improvements.

You can see what action we told the provider to take at the back of the full version of the report.