Lewisham Enablement Service

Ladywell Centre is a domiciliary care agency. The service provides reablement and rehabilitation as well as personal care for people in their own homes. People are referred to the service from local authority representatives and health care professionals. The service aims to maximise people's ability to continue living independently following discharge from hospital, following an accident or illness. At the time of the inspection the service was supporting 75 people.

People’s experience of using this service

People’s care needs and rehabilitation goals were identified by health and social care professionals and discussed with people, their relatives and other relevant representatives before plans were put in place to meet these needs.

Staff assessed risks to people’s health and wellbeing and developed plans to manage these. However, we saw no evidence of people’s care and support needs being regularly reviewed to ensure they received the appropriate level of support at all times.

Staff were required to support people to take their medicines as prescribed where this formed part of their care plan. However, records used in the administration of medicines were not always in place where required and medicines audits were not being completed accurately or reviewed to ensure they were of a good standard.

We were not assured the provider was following safe recruitment processes as staff records lacked important information. Despite requests, the provider/registered manager was unable to provide further evidence in relation to staff work histories and appropriate employment references.

Staff training data showed some gaps in learning. Spot checks to monitor staff performance were not taking place on a regular basis and feedback forms were not being routinely completed by people using the service. Although the registered manager acknowledged that quality monitoring systems had been hampered by the COVID-19 pandemic, operational systems had failed to mitigate and adapt to current circumstances.

Staff had a good understanding of the provider’s safeguarding processes and knew what action to take to keep people safe. People and their relatives told us they felt safe with the staff supporting them. Comments included, “[Staff] are very supportive”, “I feel I get the right support” and “[Staff] have kept me safe.”

There were suitable measures in place to protect people from COVID-19, including the use of protective personal equipment (PPE).

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.

People using the service, relatives, staff and most of the healthcare professionals we heard from, praised the management team for their helpful and professional attitude.

Rating at last inspection

This service was registered with us on 20 July 2020 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we had about this service. This indicated a need to prioritise the service for an inspection to review the quality of care provided.

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 will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, good governance and fit and proper persons. We made a recommendation in relation to care review and recording processes. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service. If we receive any concerning information we may plan further inspection activity.