London Care (Atlas Place)

Updated 2 December 2021

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

The inspection was undertaken by one inspector and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own properties. At the time of the inspection service was providing care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

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 it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 19 October 2021 and ended on 25 October 2021. We visited the office location on 19 October 2021.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and three relatives about their experience of the care provided. We spoke with eight members of staff including the registered manager, the quality manager and care workers.

We reviewed a range of records. This included four people’s care records and medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the registered manager to validate evidence found. We looked at training data, staff meeting notes, staff rota’s and other records.

Updated 2 December 2021

About the service

London Care (Atlas Place) is a domiciliary care agency providing personal care to people living in their own home. People receiving the service were living in an extra care setting. At the time of the inspection 17 people were receiving the regulated activity, personal care. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The extra care housing was provided in one purposes build building where people rented or part owned their own flats from a separate housing provider and London Care (Atlas Place) provided support to people who needed it. On site was a restaurant, hairdresser and activities. These were arranged by the housing provider and therefore were not looked at during this inspection.

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

People’s experience of the service was mixed. Comments included, “I am completely happy and don’t have a single concern.” And, “I wouldn’t go so far as saying that I am happy with them, but they are adequate.”

Staffing had been at reduced levels with some care and office staff having left. Whilst the provider was acting to address this some people and their relatives did express this had had an impact on some aspects of their care. The management of quality performance and the maintenance of records needed to be improved.

People’s needs had been assessed. However, assessment had not always been used to develop people’s care plans. Risk assessments were not always in place where they needed to be. The current staff knew people well and were able to support their needs. However, the new staff would not have the information they needed to support people. Staff told us they relied on each other or the person they supported to share information with them about some health risks.

Where incidents and accidents had occurred, these had been reported. However, incident records were incomplete. Actions taken had not been recorded. The system to monitor incidents and analyse trends was not being effectively used to minimise further risks or incidents.

Staff knew people well. Where people needed support to communicate staff were aware of this. However, how people expressed themselves was not well recorded which would mean that new staff may not have the information they needed to support people as well as they could do.

Most people told us staff were kind and caring. However, some people told us staff were rushed and that this impacted on how well treated they felt. Staff were recruited safely. People received their medicines as prescribed. Staff had completed medicines training and their competency was assessed. People were protected from the risk of infection and safeguarded from abuse.

People were happy with the support they received with eating and drinking. Where people needed support to access healthcare this was in place. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff were aware of the Mental Capacity Act 2005 and understood that people had the right to make decisions for themselves where they had the capacity to do so.

The service worked in partnership with other services. This included where people needed support at the end of their life.

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

Rating at last inspection

This service was registered with us on 11 April 2019 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date the service was registered.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.