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Archived: Lambeth and Southwark Mencap

Overall: Requires improvement read more about inspection ratings

43 Knights Hill, London, SE27 0HS (020) 8655 7722

Provided and run by:
Lambeth and Southwark Mencap

All Inspections

6 September 2018

During a routine inspection

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.

30 March 2016

During a routine inspection

This announced inspection took place on 30 March 2016. The service was last inspected on14 January 2014. The service met all the regulations inspected at that time.

Lambeth Mencap provides community support services to people with a learning disability living in their own home and 24 hour supported living accommodation. At the time of this inspection the service was providing support to 106 people. The service had a registered manager. 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.

The service was safe. Staff were trained to safeguard people. They knew the signs of abuse to be alert to and the actions to take should they suspect it. People’s risks were assessed to prevent avoidable harm and their risks were reassessed when their needs changed. Staff were recruited through a safe and thorough process and there were sufficient numbers of staff to support people’s needs safely.

Staff were supervised by their line managers and received training to keep their skills and knowledge up to date. New staff were taken through an induction process. All staff received an annual appraisal.

People were supported to make choices about the care and support they received and their communication needs were met. Staff supported people in line with the principles of the Mental Capacity Act (MCA) 2005 and the requirements of Deprivation of Liberty Safeguards (DoLS).

People were supported to eat nutritious food. When assessments of people’s swallow safety identified choking risks staff had clear guidelines on supporting people to eat safely. People had timely access to healthcare services whenever they needed.

Staff were compassionate towards people and treated people with respect and dignity. People’s diversity was recognised and their cultural needs were met.

The service had a registered manager who staff said was open, approachable and ensured effective communication throughout the service. Quality assurance audits were systematically undertaken to drive up improvements in the service being delivered to people. The provider worked collaboratively with other service providers and with health and social care professionals.

30 January 2014

During a routine inspection

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We read the records of four people who used the service. We saw they all included care plans and service delivery plans that had been agreed with the people who used the service. The people we spoke with confirmed that the staff from the service had visited them to discuss the service prior to them consenting to the service.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. All the records contained referral forms that had been completed by the person using the service, their relative, or a referral agency. We saw that plans had been written with the person who used the service.

People were supported to be able to eat and drink sufficient amounts to meet their needs. The records we read contained information about people's dietary requirements. Staff told us information in the files and discussions with people who used the service was used to support people to have balanced diets.

Staff told us they felt supported and that the service provided them with training and development that enabled them to do their jobs well.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. We saw that customers were regularly asked to give their views of the service through customer feedback forms. We saw forms were made available in formats that could be understood by the people who used the service.

23 January 2013

During a routine inspection

We visited the agency head office where a number of services are delivered. We spoke with three people using the service, and to five relatives. Staff provided by the agency are called support workers; we spoke with nine support workers and two operational managers.

One person we spoke with required support twenty four hours a day. They said," I don't get anxious and have seizures less frequently, I have a small group of staff that I like and who work well with me, they help me stay well and safe and ensure that I keep in contact with my family".

Another person spoken with had come to the head office, they said 'I can do more for myself and more independent thanks to the encouragement I received from staff, I would struggle with looking after myself without the help of my lovely support worker".

Staff employed by Lambeth Mencap told of receiving the training and development they required to successfully support and empower people. Staff working in dispersed situations in the community received the support and supervision they required to carry out their duties effectively.