Archived: London Care (Holloway)

Updated 25 February 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.

The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to ensure that the manager and other people we needed to speak with were available. We carried out an inspection visit to the agency on 8 January 2016. This inspection was carried out by three inspectors, two visited the agency offices and one carried out telephone interviews of people using the service and care workers.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We looked at notifications that we had received and communications with people’s relatives and other professionals. These included information from local authority safeguarding teams, other notifications and examples of how the service had responded to complaints.

During our inspection we spoke with two people using the service, four relatives, four care workers, two care co coordinators, the registered manager and received feedback from a local authority commissioning team manager.

We gathered evidence of people’s experiences of the service by conversations we had with them and by reviewing other communication that the service had with these people, their families and other care professionals.

As part of this inspection we reviewed ten people’s care plans and care records. We looked at the induction, training and supervision records for the staff team. We reviewed other records such as complaints information, quality monitoring and audit information.

Updated 25 February 2016

London Care is a domiciliary care agency which provides services to over 300 people, mostly in north London. The service predominantly caters for the needs of older people but also younger people with disabilities or other support needs.

This inspection was short notice which meant the provider and staff did not know we were coming until shortly before we visited the service and our inspection was carried out on 8th January 2016. At the last inspection on 12 January and 9 February 2015 the provider was not meeting all of the requirements we looked at. At that time we found breaches of Regulation 10 (Now regulation 17 of the amended regulations - Good governance) and Regulation 11 (Now regulation 13 – Safeguarding service users from abuse and improper treatment) We had also made three recommendations in the areas of Safe, Effective and Well – Led. At this inspection we found that the provider had taken action to address the breaches and respond to the recommendations.

At the time of our inspection there was a registered manager in post. 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.

From the telephone discussions we had with people using the service and relatives we found that people were usually satisfied with the way the service worked with them. People felt able to contact staff at the agency to discuss anything they wished to and care workers were usually viewed as having the right skills to care for people.

In all of the care plans we looked at we found that the service had improved. Risks associated with the care to be delivered were identified and reviewed and were changed whenever any risks were assessed as having changed.

The service had access to the organisational policy and procedure for protection of vulnerable adults from abuse. We asked staff about how they would recognise any potential signs of abuse. All but one member of staff was able to confidently tell us about what they would do; the one who didn’t at first gave clearer responses when prompted. The care coordinators we spoke with said that they had training about protecting vulnerable adults from abuse and were able to describe the action they would take if a concern arose.

We spoke with the manager who explained the system used by the provider for both mandatory and optional training courses. We found the mandatory training covered core skills and knowledge for staff and induction training was in line with the Skills for Care Common Induction Standards and the care certificate.

The agency had detailed policies, procedures or information in relation to the Mental Capacity Act 2005 (MCA). The provider informed us that they were aware of three people using the service who were subject to enduring power of attorney. It should be noted that the agency would not have responsibility for making applications under this legislation. However, they would have responsibility for ensuring that any decision on the MCA 2005 were complied with. Care staff we spoke with demonstrated understanding of this area.

The people that we spoke with were generally very satisfied with the care workers they used and their knowledge and ability to provide care and support.

The care plans we looked at drew attention to individual needs such as how people communicate, their cultural identify and first language. The care plan format contained a short pen portrait of the person as part of the information available to care staff. This helped to provide information which assisted care workers to form a good rapport with the people they cared for.

We found that any complaints that had been made in the last year had been responded to appropriately.

The care provided by staff was clearly set out in all the care plans that we looked at. This included information about people's preferences and individual needs. For example, the times when carers were to call at people’s homes to deliver care was stated along with the numbers of carers required.

Staff members and professionals that we spoke with told us they felt improvements had continued to be made and clear and effective communication between care workers and office based agency staff was usually effective.

There was a clear management structure in place and staff were aware of their roles and responsibilities. Further changes had been made recently with the aim to address issues around the structure and co-ordination of the service.

In discussion with the manager and care co coordinators during our inspection we were told about, and shown, the monitoring systems for the day to day operation of the service. Staff had specific roles and responsibilities for different areas and were required to report to the manager about the way the service was operating and any challenges or risks to effective operation that arose. The systems included monitoring visits and phone calls to people using the service, ongoing contact with placing authorities and monitoring of visits to ensure they were happening at the right time. If late or missed calls arose we found that these were responded to quickly.

The service sought people’s views at least annually and we saw individual examples of feedback that had been received. There was now a formalised system for carrying out recorded surveys apart from people using the service, either quarterly or at least annually. Feedback was also being obtained from staff employed and other professionals in contact with the service.

As a result of this inspection we found that the service was meeting all of the regulations that we looked at.