London Care (Basildon)

London Care is a domiciliary care agency providing the regulated activity of personal care to people who live in their own houses and flats. At the time of our inspection there were 96 people using the service.

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

There were systems in place to monitor, maintain and improve the quality of the service. People and relative’s spoke positively about the leadership of the service. However, whilst staff spoke about their passion and commitment for the work they do, the majority of staff told us they felt unsupported, communication was poor and any issues or concerns they raised either with the office staff or management team were either not responded to or not followed up.

Staff felt confident their training provided them with the knowledge they needed to support people safely. People told us they received safe care from staff who knew them. There was a safeguarding policy in place and the registered manager, and staff knew how to identify and report concerns. The service had enough staff to meet the needs of people using the service. Staff had been safely recruited and pre-employment checks carried out.

Staff had received training in medicine administration. People told us they received their medicines on time. Staff told us they had access to personal protective equipment (PPE) and there were effective infection control measures in place. People confirmed appropriate PPE was worn by staff when being provided with care and support.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 4 January 2018).

Why we inspected

This inspection was prompted in part due to concerns received about people’s care and treatment and poor conduct of managers and office staff. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains good based on the findings of this inspection.

Follow up

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

London Care (Basildon) provides a domiciliary care service for people living in their own homes in the Basildon and surrounding areas. It provides a service to older and younger adults. The inspection took place from 26 October to 6 November 2017 and was announced. This was to ensure that someone would be at the office to meet with us. At the time of our inspection 120 people were receiving personal care and support from the service.

There was a registered manager in post at the service. 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.

People who use the service and their relatives were positive about the care they received and praised the quality of the staff and management. Comments included, “The service is absolutely fine and the staff are brilliant,” and, “I am quite happy with them and have no problems whatsoever,” and, “I think they are friendly, they get on with their job, I am very grateful I have very good staff,” and, “I have been with them for 12 years so they must be doing something right.”

People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm and staff knew how to keep people safe. Risk assessments had been completed so that staff knew how to keep people and themselves safe.

There were sufficient staff with the right knowledge and skills to meet people’s needs. Staff had been recruited safely. Staff had the competence and skills to administer medicines safely and as prescribed and there was a system in place to protect people from the risks of infection. The provider recorded, reviewed and investigated incidents and accidents and took the necessary action.

People’s needs were holistically assessed and support delivered in line with current guidelines. Staff were provided with training and supervision in order for them to carry out their role effectively. People’s health needs were met as staff liaised well with health and social care professionals. People were supported to be able to have their meals as and when they wanted them which met their nutritional needs.

People consented to their care arrangements and people’s capacity to make day to day decisions was assessed and recorded. People’s end of life wishes were taken into account and care provided accordingly.

People told us that staff were caring and kind and were respectful of them and their property. The service was responsive to people’s needs and wishes as they listened and involved them in their care. Positive relationships had been maintained. The service was meeting the Accessible Information Standard by ensuring people’s sensory and communication needs were met.

There was an effective complaints procedure in place and people and their relatives knew who to contact if they needed to. The provider regularly assessed and monitored the quality of the service provided. Feedback from people, their relatives and staff was encouraged with regular telephone contact and reviews and these were used to make improvements to the service.

Concerns were stated by people using the service in relation to poor communication with the office. For example people told us they were not always being informed when staff were running late and when there was a change to their usual member of staff; and improvements were required.

Records viewed showed that support plans covered all aspects of a person's individual circumstances. The provider had appropriate arrangements in place to ensure that staff were appropriately trained to meet their personal care needs and that staff were regularly supervised and appraised. People who used the service were confident that their comments and complaints were listened to and acted on. We found that improvements were required with regards to the management of medicines.

We found at this inspection that significant effort had been made by the provider to address previous identified shortfalls. It was evident that the provider had taken our concerns seriously. We found that mandatory training for staff in key areas had been provided since our last inspection. We also found that staff had received supervision and appraisals.

We found that each person's support plan had been reviewed and updated. We also found that all staff files had been streamlined so as to make them more efficient.