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Inspection Summary


Overall summary & rating

Good

Updated 4 July 2018

We inspected London Care [Ensham House] on 09 May 2018. This was an unannounced inspection.

At our previous inspection on 17 & 24 August 2017 we found the provider was not meeting regulations in relation to the outcomes we inspected and we issued a warning notice in relation to Good Governance. At this inspection, we found the provider had met the breaches we found at the previous inspection.

At the last inspection, the service was rated Requires Improvement.

At this inspection, the service was rated Good.

London Care [Ensham House] provides personal care and support to people living in an extra care housing scheme. This consists of 45 individual flats within a staffed building with some communal areas. At the time of our inspection there were 43 people using the service. A separate organisation manages the building. Not everyone using London Care [Ensham House] 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.

There was a registered manager 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 2008 and associated Regulations about how the service is run.

The registered manager was relatively new and had been in post since January 2018. People using the service, relatives and staff were positive about the impact he had and the improvements he had made since he had started. This include changes to the allocation of staff on their daily shifts which they felt were more responsive to people’s needs.

People told us they felt safe living at the service and that care workers were kind and caring towards them. People received appropriate support in relation to their medicines. They told us they felt supported in relation to their health and nutritional support needs. However, a common theme in our conversations with people were that care workers were rushed and did not support them much above and beyond the basic level of care.

People lived independent lives and any restrictions in place were in line with the Mental Capacity Act 2005, in their best interests.

Staff told us that their rotas had improved and there were enough staff to support people. They spoke positively about the training and supervision they received. The training covered areas of care that were deemed mandatory and supervision was based around staff performance and in areas relevant to their roles such as medicines.

The provider had robust recruitment checks in place and carried out appropriate checks to ensure suitable staff were employed. At the time of the inspection, there were upcoming changes being considered for the makeup of the senior team within the service.

An assessment of care needs was completed before people came to use the service which looked at the risks to people and how they could be made safe. Care and support plans included goals and outcomes that people wished to achieve and how people could support and assist them to achieve their goals.

Records such as complaints, incident and accident monitoring and medicine administering records were completed appropriately.

The provider had an appropriate system in place to check the quality and safety of the service people received. The regional manager undertook periodic audits that included general information and focussed on a specific topic, such as medicines or people’s personal care and support records. We saw that the overall compliance scores were improving as each audit was undertaken.

Inspection areas

Safe

Good

Updated 4 July 2018

The service had improved to Good.

Risk assessments were carried out before people began to use the service.

People told us that they felt safe. Care workers received safeguarding training and were aware of reporting procedures.

The provider had robust recruitment checks in place. We received mixed feedback from people in relation to timeliness of care workers, however the registered manager had tried to make improvements in this area.

Care workers supported people to take their medicines.

Effective

Good

Updated 4 July 2018

The service had improved to Good.

Care workers received mandatory and thereafter received regular ongoing supervision.

People’s consent to their care and support was taken.

People were supported with regards to their health and nutritional needs.

Caring

Good

Updated 4 July 2018

The service remained Good.

Responsive

Good

Updated 4 July 2018

The service had improved to Good.

Complaints received were recorded appropriately and records showed they had been acted upon.

Care plans were developed in collaboration with people.

Well-led

Requires improvement

Updated 4 July 2018

The service had improved to Requires Improvement.

The provider demonstrated they acted upon feedback received via quality assurance checks.

People, relatives and staff were hopeful that the new registered manager would have a positive impact on the delivery of the service.