Archived: Lambeth and Southwark Mencap

Updated 12 October 2018

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.

This inspection took place on 6 and 7 September 2018 and was announced. On the 4 September 2018 we made calls to people and their relatives as well as staff that worked at the service.

We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

The inspection was conducted by one inspector. An expert-by-experience made calls to people and their relatives. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience had knowledge of caring for people with learning disabilities.

Prior to the inspection we reviewed information we held about the service. This included notifications the provider is required by law to send us about events that happen within the service. We also reviewed the information included in the 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 the care records for four people. We also made contact with three people that use the service and four relatives. We spoke with six support workers, one care co-ordinator, one team leader, the registered manager and the director. We also looked at five staff files and documents relating to the overall management of the service which included quality assurance audits, medicines administration sheets, complaints records, and accident and incident reports.

Updated 12 October 2018

This inspection took place on 6 and 7 September 2018 and was announced.

The service provides domiciliary care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults.

The service also provides care and support to people living in two ‘supported living’ settings, so that they can live in their own home 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.

Not everyone using Lambeth and Southwark Mencap receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of this inspection 18 people were receiving the regulated activity.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post at the time of our inspection. 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.

At this inspection we found that the provider was in breach of the regulations in relation to staffing and good governance. You can see the action we have told the provider to take about these breaches at the back of the full version of this report.

Staff were not up to date with the provider’s training, supervision and appraisal requirements. Where quality assurance audits had identified areas for improvement, prompt action had not always been taken to address them; nor had regular feedback from people and relatives been sought.

Improvements were required to ensure care plans were personalised enough to clearly reflect people’s preferences in how they wished to be cared for.

The provider had commenced improvements in the recording of people’s medicines administration, including implementation of a new medicines administration record (MAR). People’s care plans did not include a record of people’s medicines and what they were for, however the provider took immediate action to address this.

People and their relatives told us that office staff did not always communicate non attendance of calls, although records we looked at showed that there was appropriate contingency management to ensure people’s needs were met.

People had appropriate risk assessment and management plans in place that ensured staff were equipped to support people in mitigating any risks to them. Staff were knowledgeable in how to safeguard people from abuse and were aware of the appropriate reporting mechanisms. Records showed the provider dealt with safeguarding concerns in a prompt and sensitive manner. Staff knew the steps to take to effectively prevent the spread of infection. Incidents and accidents were well managed and action taken to make improvements.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported to make decisions in their best interests.

People were supported to access healthcare professionals at times that they needed them. People’s food and drink preferences were met, whilst being supported to maintain a balanced diet and access appropriate support at mealtimes.

Staff knew the people they cared for well and were passionate about ensuring they delivered good quality care. People and relatives felt well cared for and that their privacy and dignity was respected. People were supported to be as independent as they were able to be.

People and their relatives knew how to make complaints, and records showed that complaints were promptly responded to with appropriate action taken to find solutions. Systems were in place to support people to express their end of life wishes if required to do so.

People, relatives and staff were positive about the communication and support they received from management. The registered manager ensured that important information was shared with the CQC and worked with other agencies to ensure the service was up to date with local developments.