Archived: London Community Homecare Ltd

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with staff and with people using the service and from examining records. If you want to see the detailed evidence supporting our summary please read the full report.

At the time of our inspection there were approximately one hundred and eighty people using the service within several London borough's. To meet the needs of people using the service there were approximately ninety nine care workers based within these communities. As part of our inspection we met with the manager and the provider's head of care, spoke with nine members of staff, met and spoke with the providers external trainer and spoke with twenty two people who use the service and or their representatives.

Is the service caring?

People who use the service were not always given appropriate information and support regarding their care and treatment. We looked at the care records of twenty five children and adults who use the service. We noted that many of the care plans we examined did not have a signed consent form indicating that people using the service had been involved in the initial assessment process prior to starting the service. Of the twenty five care plans we examined seven did not have a completed provider's assessment form. This meant that the provider did not formally assess the needs of people using the service prior to the commencement of the service or throughout the delivery of care. People's needs may not have been met appropriately and the support provided may not have always been tailored to people's individual needs.

People's diversity, values and human rights were not always considered or respected. Care plans we looked at did not include detailed information on people's lives and personal histories or about people's interests and preferences. There was little recorded information about people's religious and cultural needs or due regard to people's age, sexual orientation, linguistic background and racial origin. They was no guidance for staff on how they supported or respected people in relation to this. This meant that people's individuality and diversity was not always considered or respected.

Is the service responsive?

People told us that, up until recently, they had experienced a high number of occasions when their care and support needs had not been met. This was because carers had not been available to support them at the agreed times or had missed their call. Some people also told us that carers did not always spend as much time providing support as had been agreed. Other people told us that the number of 'missed calls' had reduced recently. One person told us 'I need the support from two carers; however there are many occasions when only one carer turns up'. Another person said 'There has been several times when no one has visited me. I have managed on my own but it's not helpful when they don't come'.

We saw that people's care records were not always accurate and fit for purpose. Of the twenty five care records we looked at five did not include a care plan of people's needs and wishes. The providers care plan tool did not encourage the involvement from people using the service and did not accommodate people to sign their agreement to the information that had been recorded about them. There were no detailed care plans to provide staff with the information they needed to ensure individualised care and support to people using the service.

Is the service safe?

People that we spoke with using the service told us they felt safe receiving care from the service and had never seen anything that caused them concern. People told us that they were confident about speaking to care workers that visit or the manager if they had any concerns. One person told us 'I feel safe in my own home and the carers that visit me are very nice and helpful'. Another person said 'I feel confident that if I did have a concern the service would listen to me and act as appropriate'.

The manager told us that all members of staff upon induction with the service were provided with an identification badge. This meant people who used the service were able to identify workers when they entered their homes. The manager also informed us that new staff members were issued with a staff handbook which detailed the provider's health and safety at work policy and how staff were required to respond in certain situations. The provider's recruitment procedures ensured that all required legal checks were completed. This meant all checks had been completed to try and ensure that only staff suitable to work with vulnerable adults and children were employed by the provider.

Is the service effective?

We spoke with the registered manager about the concerns raised with regards to 'missed calls'. They informed us that the service acknowledged that this had been a problem and they had sought to address it by installing an Electronic Call Monitoring system (ECM). They explained that this system worked by letting the office staff know when a care worker has entered a service user's home and when they leave. At the time of our inspection the ECM system had been installed but was not operational. Efforts by the provider were being made to ensure the system was operational and working correctly.

We examined the supervision and training files of five members of staff. Training records we looked at confirmed that staff members had attended and successfully completed up to date training in a broad spectrum of health and social care areas. Staff member's training certificates were kept within individual supervision folders. Supervision folders we looked at demonstrated that staff were provided with regular supervision and support and had received an annual appraisal.

Is the service well-led?

There were effective recruitment and selection processes in place. Staff we spoke with told us they had been recruited by completing an application form and attending an interview where they were asked questions which were relevant to their role. Qualifications staff had gained prior to starting work were checked. One person told us 'The recruitment process was good and my induction period was helpful to me when learning the job'.

People who use the service told us they were able to contact the service when required and they were always able to speak with someone. People had their comments and complaints listened to and acted on, without the fear that they would be discriminated against for making a complaint. People we spoke with were aware of the services complaints policy and told us they knew they could contact the office if they had any concerns. One person told us 'I have had some problems in the past when I have spoken to the office. I must say they did sort it out for me'. Another person told us 'There has been an occasions when I called the office. They were helpful and the problem was resolved'.

We found that care was planned and delivered in line with people's assessed needs and care plans were updated on a regular basis. The provider trained staff in safeguarding vulnerable adults and other important issues and people told us they felt safe with the care staff. We saw that staff were supervised and their competency was monitored on a regular basis. Staff told us they felt supported in their work. The provider had effective recruitment procedures in place to ensure only suitable people were employed by the service. We found that the provider had systems in place to monitor the quality of the service and had taken action where necessary to improve the service for people.