Lambeth Chinese Community Association

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection we rated this key question good. At this assessment, the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to safe care and treatment.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not continually identify and embed good practice in relation to lessons learned.

There were no records to show managers reviewed concerns and implemented preventative measures. The service did not have a comprehensive accident or incident recording system in place at the time of the assessment. We saw incidents were recorded on a Home Visit Form document. We saw 1 record which documented basic information about a person feeling unwell. There was no information about investigations into why the person was feeling unwell, or action taken to assess, review or address the concern raised.

However, people told us they were able to raise a concern with staff or with the management team and they were confident their concerns would be investigated.

Staff told us they would contact the registered manager with any concerns they had, then they were confident concerns would be listened to and acted upon.

The service had the complaints policy for staff to follow. The management team told us there had been no accidents. Or incidents in the past 12 months prior to the assessment.

The provider did not ensure safe systems, pathways and transitions were in place for people.

People had care plans and risk assessments. However, these did not contain sufficient information about how to support people with their care needs. For example, we reviewed care plans where the reason the person was receiving regulated activity was not clear from the information available. This meant people would have to repeat the story of their care needs if they were transitioning from one service to another. It also meant they were at risk of being supported by staff who were not informed of their support needs.

At the time of the assessment, no people were transitioning between services. People told us they were supported by staff and the management team to arrange and attend healthcare appointments as required.

The provider did ensured staff understood how to improve people’s lives while protecting their right to live safely.

Staff told us they had received training in safeguarding adults, and they knew how to protect people from abuse and bullying. The service had a safeguarding policy in place for staff to follow to keep people safe. People and their relatives told us they felt safe with staff. A relative said, ‘I am happy with [family members] care.’

People and their relatives told us they felt confident in contacting the registered manager if with a safeguarding concern if they needed to. At the time of the assessment, the service had not raised any safeguarding concerns or sent any notifications to CQC.

The provider did not always work well with people to manage risks.There was not enough information in care plans and risk assessments to inform staff how to support people safely. For example, risk assessments did not record the type of diabetes people had, or how blood sugar levels should be monitored or managed. This put people at risk of being supported by staff who were not adequately informed on how to manage their health care needs safely.

The registered manger told us all risks were assessed and discussed thoroughly with people at the beginning of their care, and throughout. However, this information was not adequately documented for staff to follow.

The provider ensured peoples care was delivered in a safe environment.Home risk assessments ensured staff were delivering care to people in a safe environment. Staff told us they had received training in health and safety and understood how to maintain a safe environment for people.

The registered manger told us unannounced spot checks were carried out to ensure staff were delivering care effectively and maintaining a clean and safe environment for people. Feedback from staff confirmed this.

The provider did not always make sure staff were qualified to support people. Staff had not received all required training in line with Care Certificate standards to support them to keep people safe. There was no training delivered or planned in relation to supporting people with dementia, despite the service supporting people living with these support needs. This meant people were being supported by staff who had not been trained to support them safely. The management team told us the lack of training was due to not being able to find provider who could deliver relevant training in the languages spoken by staff.

Recruitment files reviewed did not include employment histories for some staff and no prior work references documented. We raised these concerns with the management team. We were told that staff had been employed prior to the current management team were employed.

The service had carried out Disclosure and Barring Service (DBS) checks for all staff. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. All staff did have DBS checks in place.

Staff had been employed at the service for many years, and they knew the people they supported well. People told us they were happy with the care staff who supported them, and felt staff were well trained to provide care appropriately.

The provider assessed and managed the risk of infection.People told us staff wore personal protective equipment (PPE) appropriately and when required. Staff told us they had no issue with acquiring PPE to support people safely, and staff collected PPE from the office when needed.Staff told us they had received training in infection control, and this training was completed annually.

The registered manger told us they have an overstock of PPE to ensure continuous availability for staff. Staff were responsible for collecting PPE and ensuring people had a good stock in their homes.

The provider did not always make sure that medicines and treatments were safe.Staff told us they received training to support people with their medicines. However, the provider did not keep records confirming staff’s competence or suitability to administer medicines. The provider did not document how staff competency was assessed.Risk assessments had information of which medicine staff were to support people with. However, care plans did not include information of how staff should support people with medicines, or if medicine support was required. We fed this back to the management team who told us staff was told how to care for staff with their support needs.

People told us they were happy with the support they received with their medicines. Staff told us they received refresher training to support people with medicines every year.