Essex/London

Updated 4 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by two inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care and support to people living in several supported living settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

Before the inspection, we looked at information we had received about the service. This included any notifications from the provider. Statutory notifications included information about important events which the provider is required to send us by law. We also used the information from the provider since our last inspection outlining the action’s they were taking to improve the service.

During the inspection

We spoke with one person who used the service and two relatives about their experience of the care provided. We received information from two members of staff. We also spoke with the registered manager/provider. We reviewed a range of records. This included four people’s care records and medication records. We looked at records relating to recruitment and staff supervision and a variety of records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 4 March 2020

About the service

Essex/London is a domiciliary care agency which provides personal care to people in their own home. The service supports some people on a 24-hour basis and others who may require support with personal care needs at specific times during the day and /or night. The service was supporting people with personal care at the time of our inspection. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. At the time of our inspection the service was providing support packages to four people.

People’s experience of using this service and what we found

The registered manager demonstrated a commitment to improving outcomes for people and responding to concerns raised at the last inspection. Support had been given by an external consultant. A family member told us, “I have definitely noticed a difference in the last few months there is a lot more paperwork, the staff are always writing things down that they have done.”

Feedback from people we spoke to was positive. People had been fully communicated with the outcomes of the last inspection and the necessary improvements the registered manager needed to make.

The registered manager had improved people’s care plans. Clear risk assessments were in place along with people’s likes dislikes and health needs. Quality assurance processes were in place and audits were carried out and outcomes actioned. However time was needed to ensure these improvements were sustainable.

Recruitment processes had been improved so people received safe support from people when they needed it. However, staff personnel files were disorganised and did not contain all of the relevant information required.

The administration of medicines was safer than at our last inspection. Staff had been re-trained and there were effective audits in place to pick up any errors. However, these had not always been effective in picking up a recording issue on the medicine administration record sheet ( MARS).

Staff had received some training to enable them to have the right skills and experience to meet people's needs. However, some training had yet to be arranged.

Assessments were carried out to ensure people's needs could be met.

Staff understood people's likes, dislikes and preferences and people told us they were offered choices about their care.

People were supported to eat and drink in line with their preferences.

People were supported to have maximum control of their lives and staff supported them in the least restrictive way possible and in their best interest.

Relatives and staff were complimentary about the management of the service. Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service.

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

Rating at last inspection inadequate. (published 18 June 2019)

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

The service had been in Special Measures since 18 June 2019. During this inspection the provider demonstrated that improvements had been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.