All inspections: London Care (Shepperton)

The inspection took place on 12 April 2016 and was announced. We gave the provider 48 hours' notice because they offer a domiciliary care service and we wanted to make sure someone would be available.

The last inspection of the service was on 19 May 2014 when we found there were no breaches of Regulations.

London Care – Shepperton is a domiciliary care agency providing personal care and support to people who live in their own homes within Northwest Surrey. The majority of people using the service were over the age of 65 years, although some younger adults also received care. At the time of our inspection there were 109 people using the service. London Care Limited is part of a larger national organisation, City and County Healthcare Group, providing personal care to adults in their own homes, extra care schemes and other care services.

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 and associated Regulations about how the service is run.

Some of the things people said about London Care – Shepperton were, ''They do a very good job'', ''They are excellent, nothing I can say to improve things, they do a wonderful job'', ''They have helped me in more ways than you can imagine'' and ''I have been getting stronger since they started helping me, you get a buzz when things keep getting better and it’s down to them.''

There were procedures which were designed to keep people safe and protect them from abuse.

The risks to people's wellbeing and safety had been assessed and the staff had information about how to keep people safe.

People received the medicines they had been prescribed in a safe way.

There were procedures to be followed in event of an emergency and the staff were aware of these.

There were enough staff to meet people's needs and keep them safe. The staff had been recruited in a suitable way.

People told us they had been consulted about their care and had agreed to this.

People were cared for by staff who were appropriately trained and supported.

People had the support they needed to meet their nutritional needs.

People were given the support they needed to stay healthy. People were cared for by kind, considerate and polite staff. They had good relationships with the staff and the staff understood the need to respect people.

People's privacy and dignity was respected.

People were supported to stay independent in areas they wished and were able. People's care needs had been assessed, recorded and were being met.

People felt confident raising concerns with the agency and told us complaints were investigated and acted upon.

The manager was appropriately qualified and people felt able to speak with them and senior staff about the service.

People were consulted about their own care and the staff were also consulted about the agency.

There were a range of audits and checks to make sure the service met people's needs.

Records were well maintained, accurate and up to date.

London Care (Shepperton) is a domiciliary care agency providing personal care for people in their own homes. At the time of our inspection the service supported 153 people.

The Care Quality Commission (CQC) last inspected London Care (Shepperton) in January 2014. At this inspection we found that the service was in breach of Regulation 23 of the Health and Social Care Act 2008. This was because staff had not received training, supervision and appraisals to maintain their professional development. The service sent in an action plan which detailed the actions they would take to meet the regulation.

During this inspection, we found that the service had met the requirements of Regulation 23 of the Health and Social Care Act 2008. We saw that staff had been provided with training that enabled them to provide safe and effective care. All staff members apart from two had received their yearly appraisal. An appraisal is a yearly development review. Staff we spoke with confirmed that the training opportunities had improved and they felt supported in their role.

A registered manager was not in post. A registered manager is a person who has registered with the CQC to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider. A branch manager had been appointed who provided day to day leadership and support to the staff. The branch manager informed us they were in the process of registering with CQC.

The service had good systems in place to keep people safe. Assessments of the risk to people from a number of foreseeable hazards had been developed and reviewed. However, we found one instance where a person was at high risk of falling but a risk assessment was not in place. The person had not suffered any falls and the branch manager began implementing a falls risk assessment for this person immediately.

People were supported by a dedicated team of care workers. The service had sufficient numbers of staff to safely meet people’s care needs. Where people required the assistance of two care workers, we saw that two care workers attended to that care call.

People told us they were involved in the planning and review of their care. The delivery of care and treatment was recorded and each person had an individual care plan and had signed to show their agreement with its content.

Care plans were personalised to the person and contained information which was important to them. For example, their life history and what tasks they would like the care workers to help them with at home. People’s needs and choices had been clearly documented in their care plans. Where people’s needs changed the service acted quickly to ensure the person received the care and treatment they required. One person told us, “If I ever feel unwell, they always call my Doctor for me.”

People told us they were able to make their own decisions about their care and support. One person told us, “I’ve recently reduced my package of care, it was my decision and I was supported by the agency.” Where people were unable to do this, the service considered the person’s capacity under the Mental Capacity Act 2005 (MCA) and reported any concerns to the local authority.

People who used the service and their family members whom we spoke with all agreed that people were supported by kind and caring staff. One person told us, “They look after me well.” Staff were able to tell us about the people they supported. People told us their preferred name was always used by staff and this was recorded in their care plan.

We visited London Care Plc (Shepperton) to see if they had made improvements following our previous visit on 18 September 2013.During that previous visit we identified a number of concerns which related to respecting and involving people; care and welfare of the people who used the service; safeguarding people from abuse; staffing; supporting workers; and assessing and monitoring the quality of service provision.

After this follow up visit we conducted telephone interviews with eight members of staff, seventeen people who used the service and three relatives.

During this follow up visit on 22 January 2014, we saw people were respected and involved in their care and support. A person who used the service told us 'Staff are encouraging and I can do things like make my bed and empty the commode or walk to the door.'

People received care and welfare that met their needs. A person who used the service told us 'I feel I have good choice.' During our follow up visit, the people who used the service told us that they felt safe with all the staff that visited them.

There were enough qualified, skilled and experienced staff to meet people's needs.

During this follow up visit, we saw that the provider had not made all of the improvements regarding supporting staff, that were required to be compliant with the regulations.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

At the time of our visit there was no registered manager in place.

We visited the service in response to concerns raised. We spoke with senior staff at the office and 12 care staff during and after the visit. We also spoke with 27 people and relatives of people, by telephone.

Views from people and relatives were mixed. Some people were very satisfied with the care, particularly with their regular care staff. Others shared their concerns about recent problems and shortfalls with the care. For example, missed calls and being late for calls. Some people were told that the service could not accommodate them anymore.

People were mainly positive about the care they received from their 'regular' carers. We were told 'I can't fault the carers, they are very dedicated, cheerful and nice.' Although some people raised concerns that staff had sometimes spoken about other service users in their homes.

The service did not have the capacity to meet the needs of all the people that were registered with the service and had taken action to improve this. Concerns remained that some staff had sometimes stayed a shorter time than they needed to.

Some training and supervision was in place but some staff appraisals and training were not up to date.

We found that the provider had not always followed the agreed safeguarding procedures and there were gaps in the quality and monitoring arrangements.

We asked six people, including three relatives to tell us what it was like to have received services from London Care and each person we spoke with was positive about the service.

Each person told us that they were treated with dignity and respect. People explained that they were able to make choices about their care and we were told that they felt involved in decisions about their care.

Most people were aware of their care plan and each person confirmed that they knew where it was and that staff would always write in it when they visited.

People told us that they felt safe using the service and if they had concerns they would speak with somebody from the office. We were told that the office staff were helpful and responsive. However three people expressed disatisfaction that they were not routinely informed if for example, a staff member was going to arrive much later or earlier than planned.

The majority of the people we spoke to said that the quality of the care being provided was good and most people complimented their care staff, for example describing them as 'pretty good' and 'very nice.' One person added that they were ' Very satisfied with London Care.'

People told us that the service carried out regular quality to find out if they were happy with the service, which people appreciated.

People told us they were involved with the planning of their care, and that the manager discussed their support options with them and their families. They said matters of personal care and hygiene and overall wellbeing had been discussed.

People told us they were happy with the care and support they received from the staff. They said they were able to arrange the times of visits with the manager prior to commence using the service.

People said the manager introduced the carer and worked with the carer for the first visit, to ensure the carer understood the care needs of the person. People told us the manager makes regular telephone contact with them to ask how things are going. Also the manager comes in unannounced to observe and work with the carer. People told us they had a good working relationship with their carers.

People who used the service told us staff were kind and staff listened to what they wanted and worked with them to achieve it.

Archived: London Care (Shepperton)

All Inspections

12 April 2016

During a routine inspection

19/05/2014

During a routine inspection

22 January 2014

During an inspection looking at part of the service

18 September 2013

During a routine inspection

23 November 2012

During a routine inspection

13 October 2011

During an inspection in response to concerns