Archived: London Community Homecare Ltd

Updated 16 August 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We visited London Community Homecare Ltd on 17 and 20 May 2016 to undertake an inspection of the service. The inspection was unannounced. 48 hours’ notice of the inspection was given because the registered manager could be out of the office supporting staff or visiting people in their homes. We needed to be sure that they would be in.

The inspection team consisted of two inspectors on the first day of the visit, and one inspector on the second day. An expert by experience made phone calls to people who used the service to seek their views on the care and support the service provided. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make. We checked information that the Care Quality Commission (CQC) held about the service including the PIR, previous inspection reports and notifications sent to CQC by the provider. The notifications provided us with information about changes to the service and any significant concerns reported by the provider.

During our inspection we spoke with eight people who used the service and four relatives. We contacted the local authority and Healthwatch and spoke with one health and social care professional to gather information and obtain their views regarding the service. Healthwatch are a consumer group that gathers and represents the views of the public about health and social care. We did not receive a response from Healthwatch.

We viewed the records in relation to eight people’s care including their support plans, risk assessments, daily records and their medicines records. We also spoke with nine care workers, the care coordinator, the recruitment consultant, the team leader and the registered manager.

We also looked at records relating to the management of the service. These included eight staff recruitment and training records, minutes of meetings with staff, quality assurance audits, information packs, statement of purpose, staff rotas and a selection of the provider’s policies and procedures.

Updated 16 August 2016

We inspected London Community Homecare Limited on 17 and 20 May 2016, the inspection was unannounced. We gave the provider notice to ensure the key people we needed to speak with were available. Our last inspection took place on the 13 November 2013 and we found that the provider was meeting all of the regulations that we checked.

London Community Homecare Limited provides personal care and support for people living in their own homes. At the time of the inspection there were 68 people using the service.

The service had a registered manager. 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.

Care plans and the care provided to people demonstrated person centred care was the focus of care delivery. Advanced care wishes were written in people’s care plans on how people wished to be supported.

The provider carried throughout risk assessments in people’s homes. However, risk assessments had not always been reviewed when there were changes to people’s health and welfare.

Safeguarding concerns were reported in a timely manner and the provider took preventative measures to minimise further concerns. The provider adapted their call times to meet the requirements of the people that used the service.

Some aspects of the recruitment procedures were not thoroughly carried out to assess the suitability of the staff employed. Staff had completed a thorough induction, training and supervision that was reflective of the needs of people that used the service

There was a suitable number of staff deployed to meet the needs of the people who used the service.

Staff had a very good understanding of the Mental Capacity Act (MCA) 2005. The provider was worked within the principles of the MCA. People told us they were consulted and asked for their consent to the care they received.

The provider did not follow the appropriate systems to ensure medicines were managed safely. There were errors in the daily recording of medicines. Staff had received the appropriate medicines training.

People were supported with their nutritional and dietary requirements and this was recorded in their care plans.

Changes in people’s healthcare needs were identified by care workers and immediate intervention was sought.

People told us staff were caring and friendly and were considered be like part of the family. People and their relatives told us care workers respected their privacy and dignity when supporting them with personal care.

People told us they received person centred care that was responsive to their needs. Communication with people was highlighted in people’s care plans as being an important aspect of their well-being.

There was a free phone number for people to contact the head office so people’s concerns could be recorded and monitored to improve the way the service delivered care.

People gave positive views about the service and explained the service was easily accessible.

Staff told us the registered manager was supportive and knowledgeable about the care the service delivered to people in their homes.

Benchmarking was used by the provider to set new standards of practice. The provider had good working relationships with external stakeholders.

We found two breaches of regulations relating to the management of risks to people’s health and welfare. We have also made a recommendation about recording quality audits for the service. You can see what action we asked the provider to take at the back of the full version of this report.