London DCA

Updated 30 June 2022

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 Health and Social Care Act 2008.

Inspection team

The inspection team consisted of one inspector, an inspection manager 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 houses and flats and specialist housing.

This service provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

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

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 18 May 2022 and ended on 8 June 2022. We visited the supported living settings on 18 May 2022.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service.

We used all this information to plan our inspection.

During the inspection

We visited five supported living settings to meet with people who used the service.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with nine people who used the service, 11 relatives and 15 staff members including the registered manager, service managers and care staff.

We reviewed a range of records. This included 10 people’s care records and various staff records. We looked at and reviewed multiple documents submitted by the provider. These included policies and other information relevant to the running of the service.

Updated 30 June 2022

About the service

London DCA is a domiciliary care and ‘supported living’ service and is registered to provide personal care and support to people who have a learning disability or complex needs in their own homes. 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.

At the time of the inspection there were 19 people receiving personal care in five different supported living settings on 24/7 hour support. We visited some people who lived in self-contained flats and adapted or purpose-built houses where people had their own bedroom and sometimes individual or shared bathrooms and communal areas.

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.

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

People and their relatives told us they were happy with the care and support provided. Comments included, “We know [person] feels safe even though communication is difficult”; “[Staff] go out of their way to make things as safe as possible for [person] from checking her daily for sores to managing her feed and keeping her clean” and “[Person] feels safe and is happy with everyone and anyone there who looks out for him.”

People were protected from risk of avoidable harm. Comments included, “They look after me so well, I couldn’t ask for better”; “The staff support me good, always take me where I need to go” and “The staff help me to lock the doors and windows as I get a bit forgetful”. Staff knew how to identify and report abuse to protect people from harm. Risk assessments were carried out and management plans put in place to ensure people received care in a safe manner.

Sufficient numbers of staff were deployed to meet people’s care and support needs. People’s medicines were managed safely and administered when required.

Infection control and prevention practices at the service were in line with best practice guidelines including those associated with COVID-19.

People were supported by staff who were recruited safely and undertook an induction before they started providing care. Staff were trained and supported to ensure they met people’s needs. Staff provided care safely in manner that reduced the risk of spread of infection.

People told us they had developed positive and meaningful caring relationships with staff, most of whom had provided their care for several years. Comments included, “[Staff] genuinely care, they see [person] not as a set of difficult behaviours. He trusts them, they have a good relationship” and “[Person] is always well cared for and [staff] provide her with the help she requires.”

People’s care delivery maintained their dignity, confidentiality and privacy. Staff sought people’s consent before they supported them. People were encouraged to be as independent as possible and to make choices about their daily living.

People’s needs were assessed and met. People accessed healthcare services in a timely manner. Care and support plans were updated to reflect changes to people’s health which ensured staff provided appropriate care to each person. People felt confident to make a complaint when they were unhappy with any aspect of the service.

Checks and audits were carried out on the quality of care to drive improvement. People, staff and relatives were involved in the management of the service and their views were considered. The provider worked in partnership with other agencies, health and social care professionals and external organisations to ensure people’s needs were met.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture for those people who use the service and had a learning disability.

Right support: Model of care and setting maximises people’s choice, control and Independence; Right care: Care is person-centred and promotes people’s dignity, privacy and human rights; Right culture: Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

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 09/01/2020.

The last rating for the service at the previous premises was good, published on 23 May 2019.

Why we inspected

We inspected this service in line with our inspection methodology and because the service did not have a rating at their new location.

Follow-up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.