Archived: London Home Care Limited Head Office

We considered our inspection findings to answer questions we always ask; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Was the service caring?

People who use the services were supported by kind and attentive staff. The people we talked to said the staff treated them well and respected their privacy. People said that they were very pleased with the care they received. One person said, "They are very good, they do everything I need them to do'. Another person told us, "I am happy with the service they provide for me'. The relatives of people who we also spoke with said the care workers were caring, punctual and reliable. One person who we spoke with said, 'The care workers we've got are fine, they come on time and they do what they are supposed to do, they do what's in the care plan. They are kind and caring too'.

People who use the services told us they had discussed their care plans and that they were able to discuss relevant issues and make decisions about what they wanted to do.

Was the service responsive?

People who use the services were able to ask for changes in their care and support as their needs changed. Care plans were reviewed regularly and people told us that they felt well supported.

All the people who use the services we spoke with knew how to make a complaint. There was an appropriate complaints procedure in place and although no complaints had been made since the last inspection staff indicated that they would be supportive of anyone who needed to complain. This indicates that complaints would be investigated and action taken as necessary.

Was the service safe?

People who use the services were treated with respect and dignity by the care workers. People told us they felt safe with the service they received. Safeguarding procedures were robust and care workers understood how to safeguard people being supported.

Recruitment practice was safe and thorough. The regional manager ensured that care workers were appropriately qualified to meet the care needs of people who used the services. This helped to ensure that people's needs were met.

Was the service effective?

People who use the services health and care needs were assessed with them, and they were involved in their care and support planning. People told us that they had been involved in their care and support plans and that the plans reflected their needs. We inspected six people's care files. They included essential information about the person, needs and risk assessment information and service delivery or care plans.

Staff received regular and appropriate training and supervision to ensure they were able to meet the specific needs of people using the service.

Is the service well-led?

We saw that the service worked well with other agencies and services to make sure that people were supported in a co-ordinated way. It was clear that the main objective was to support people in relation to maintaining and developing their independence.

The regional manager and the operations manager carried out regular checks to assess and monitor the quality of services provided and took appropriate action to address any issues or concerns raised about service quality.

The views of people who use the services, their representatives and staff were listened to by the managers. Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the agency. This helped to ensure that people received a good quality service.

During our last inspection in November 2013 we found the provider did not meet one of the Care Quality Commissions (CQC) essential standards. We were concerned that important events that could affect people's wellbeing, health and safety may not have been reported to us.

The provider sent us an action plan to tell us what they were going to do to improve and meet the CQC standards.

During this visit we found the provider had improved their reporting mechanisms to the CQC and we were being notified of issues and events in a timely manner. We also looked at how the provider protected people from risk of abuse by identifying the possibility of abuse and preventing abuse from happening.This was because we had become aware of some ongoing safeguarding concerns.

We spoke with 25 people who used the service and / or their relatives on the telephone. Most people told us they were happy with the quality of care they received from HFH Homecare and the staff who provided their care were kind and understanding. One person told us 'I have a lovely carer, I've had her for ages and she treats me like gold' and another person told us 'I've been lucky, I get on with all of them, there're so good and so very kind and gentle.'

People we spoke with told us they were most happy when they had the same carer looking after their needs. One person said their carer was 'wonderful, she has been coming here for years, I can trust her with anything' and one relative told us 'they are all very nice people and they're always lovely to (my relative).' Some people were unhappy because they didn't have the same carers. One person told us 'They're very good but the only problem is you don't get the same carer all the time. I never know who's coming.' A relative we spoke with told us their regular carer 'does everything the way (my relative) likes it but this is not the case with the stand-in carer.'

A few people told us their carers did not turn up on time and sometimes had not turned up at all. People told us they had complained to their carers or to the office and most people told us things had improved. One person said 'some (carers) have turned up when we didn't want them, and others didn't turn up when they were supposed to. It's got better though.' One relative told us 'they were terrible at first, totally unreliable but they've improved now and I can trust them to be here.'

We looked at the care records for people using the service. People received a 'service user guide' which gave detailed information about the service and what people could expect in terms of their care and support. We saw how assessments had been used to develop a plan of care and support. People told us they had been involved in their initial assessment of care and most people felt their on-going care and support had been explained to them and met their individual needs.

We spoke with the managing director, the manager, a member of office staff and three carers. Carers we spoke with told us they felt well supported to provide care and treatment to people who use the service.

We were concerned that important events that could affect people's wellbeing, health and safety may not have been reported to us. We have written more about this in our report.

People's comments about the service included: "very good", "don't change anything" and "no complaints". Comments about staff included "they're very good", "they're never late", "they stay the required time", "suit me fine", "they do all I need", "they do all they are supposed to" and "they know the help I need and give it". People had not made any complaints although said they felt confident to speak with staff or the manager and that things would be addressed.

Staff said they had the required checks before they started work, had good training and the support they needed to do their job. Staff were proud of the service, saying "people who use the service are happy" and "it's a good company to work for". Staff said that they provided good care and support to individuals and had good communication with people who use the service and with each other. There were only two areas staff felt the service could be improved was around having more time to get from one person to the next and to have more regular staff meetings.