Background to this inspection
Updated
30 July 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by two inspectors.
Service and service type
London Borough of Waltham Forest, Independent Living Team is registered to provide personal care and reablement support for up to six weeks to people in their own homes.
The service did not have a manager registered with the Care Quality Commission. The current manager was undergoing the registration process with us. A registered manager similar to the provider, is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or manager would be in the office to support the inspection.
Inspection activity started on 9 July 2019 and ended on 10 July 2019. We visited the office location on 9 and 10 July 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took all the information we had into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with eight people who used the service and one relative about their experience of the care provided. We spoke with eight members of staff including the manager, a practice manager, three service coordinators and three care workers known as reablement officers.
We reviewed a range of records. These included nine people’s care records. We looked at eight staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including quality audits, monitoring reports, complaints and incidents records were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at electronic call monitoring data.
Updated
30 July 2019
About the service
London Borough of Waltham Forest, Independent Living Team provides personal care and reablement support to people for up to six weeks to enable them to regain their independence and confidence.
Not everyone who used the service received personal care. 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. At the time of the inspection, 14 people were receiving personal care.
People’s experience of using this service and what we found
Risks to people’s specific health conditions were not always explored and recorded in their care records. This put people at risk of harm. Accident and incident records did not include learning outcomes to prevent future occurrence.
People’s care plans lacked consistency and their needs in relation to their sexual orientation and gender expression were not recorded. This meant people may not have always received care that met their personal needs. The complaints’ records were not always consistently completed. The provider’s auditing systems were not always effective,
People and relatives told us they felt safe with staff. They were satisfied with staff punctuality. Staff knew risks to people and knew how to safeguard them against the risk of harm and abuse. Staff followed safe infection control procedures.
People’s needs were assessed before they started receiving care. People told us their individualised needs were met by staff who received regular training and supervision. People’s dietary needs were met, and staff encouraged them to regain their independence and confidence. People told us they received appropriate support to access healthcare services.
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.
People told us staff were caring and kind and treated them with dignity and respect. People’s needs in relation to their protected characteristics were met by staff. Staff encouraged people’s independence. People told us they were supported by same team of staff.
People told us they were involved in planning their care and were part of the care reviews. People’s personal needs were met by staff who had a good understanding of their background history, likes and dislikes. People told us they felt comfortable in raising concerns and were satisfied with the complaint’s process.
People were happy with the service and told us they would recommend the service to others. They told us the management was approachable and sought their views about the quality of the service.
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 requires improvement (published 17 January 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made but were not enough and the provider was still in breach of a regulation. The service remains rated requires improvement. This service has been rated requires improvement or inadequate for the last four consecutive inspections.
This service has been in Special Measures since 4 March 2018. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating and to follow up on action we told the provider to take at the last inspection.
Enforcement
We have identified a breach in relation to good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.