Archived: Look Ahead West London Mental Health Domiciliary Care Service

Updated 28 October 2014

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 regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process under Wave 1. This was also our first inspection of this service which we registered on 12 June 2013.

A breach of legal requirements was found. As a result we undertook a focused inspection on 29 September 2014 to follow up on whether action had been taken to deal with the breach.

Comprehensive Inspection of 1 April 2014

At the time of our inspection the provider had not had a registered manager in post for seven months. However, a manager had been appointed who was present during the inspection visit. They had applied for registration before our visit.

Before our inspection, we reviewed all the information we held about the service. We asked the provider to complete an information return. We announced the inspection to the manager a few days in advance of our visit, to ensure that the manager would be present and to help ensure that people using the service could be aware of our inspection.

We visited the service on 01 April 2014. The inspection team consisted of an inspector and an Expert by Experience who had experience of services for people with mental health conditions.

On the day we visited, we spoke with 13 people living at the two supported living schemes providing regulated activities, six staff members and the manager. We observed the support given to people in the lounge areas of the schemes. We also spent time looking at records, which included people’s support records, and records relating to the management of the service.

Following our visit we spoke with one health care professional involved in the support of people using the service. We also asked the manager some further questions and reviewed records that the manager gave us during and after the visit.

Focused inspection of 29 September 2014

We undertook an announced focused inspection of Look Ahead West London Mental Health Domiciliary Care Service on 29 September 2014. This inspection was carried out to check that improvements to meet legal requirements planned by the provider after our 1 April 2014 inspection had been made. We inspected the service against one of the five questions we ask about services: is the service safe? This is because the service was not meeting one relevant legal requirement.

The inspection was undertaken by one inspector. We spoke with the registered manager and a team leader.

We viewed references for six staff members, recruitment procedures, a sample job offer letter and the most recent staff recruitment documents audit.

Updated 28 October 2014

We carried out an announced comprehensive inspection of this service on 1 April 2014. A breach of legal requirements was found. As a result we undertook a focused inspection on 29 September 2014 to follow up on whether action had been taken to deal with the breach.

You can read a summary of our findings from both inspections below.

Look Ahead West London Mental Health Domiciliary Care Service is a community support service specialising in the support of adults with mental health conditions. It provides support services for people at two purpose-built housing schemes where people have their own flats but share some communal facilities. Both schemes provide 24-hour staffing.

Comprehensive inspection of 1 April 2014

At the time of our inspection, the service was providing 24 people with the prompting and supervision of their personal care when needed. We inspected this aspect of the service. Four of these people were also receiving direct personal care support that was arranged with local domiciliary care services. We did not inspect that aspect of those people’s services because these were not supplied by Look Ahead Care and Support Ltd.

At the time of our inspection the provider did not have a registered manager in post. However, a manager had been appointed who was present during the inspection visit. They demonstrated good leadership of the service, and they were well known to people using the service and staff.

We spoke with 13 people who use the service across its two supported housing schemes during our visit. Overall, people praised the service and the support provided. Comments included, “It’s fantastic”, “It’s very good indeed” and “It’s a good service, they look after you.” Most people told us that nothing needed changing about the service that that they were happy using it. We also received information from a community professional involved in the support services provided to some people. Their feedback complemented the service and included that they would recommend the service to friends and family.

Everyone told us that staff at the schemes were kind, understanding and compassionate. Some people told us this was their first experience of a mental health service where their dignity was consistently respected.

People told us staff had time for them. People were asked for their views about the services provided, which were acted on. There was an effective complaints system in use at the service.

People said that they received the care and support they needed. They were involved in decisions about their own support.

People had access to healthcare services and received ongoing healthcare support. The service worked in cooperation with other agencies and services to make sure people received effective care and support.

People told us they trusted staff and felt safe using the service. There were systems in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others, including for safeguarding people from the risk of abuse.  

However, we could not be assured of safe practice through the staffing arrangements at the service. Recruitment and selection processes did not take all reasonable precautions to minimise the risk of unsuitable staff being employed at the service, because staff began working with people before appropriate written references from previous employments were acquired.

The problem we found breached a health and social care regulation. You can see what action we told the provider to take at the back of the full version of the report.

Focused inspection of 29 September 2014 

After our inspection of 1 April 2014 the provider wrote to us to say what they would do to meet legal requirements in relation to staff recruitment and selection processes.

We undertook a focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. We found that references had been obtained from the previous employers for staff working at the service. Recruitment procedures had been updated to include the fact that appropriate references must be obtained prior to new staff commencing work at the service.