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Archived: London Care (Poole) Inadequate

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Reports


Inspection carried out on 12 July 2017

During a routine inspection

This inspection took place on 12, 13 and 17 July 2017 and was unannounced. London Care (Poole) provides personal care and support to people living in three extra care housing schemes. These consist of private flats within staffed buildings with some communal areas. At the time of our inspection there were 71 people who were receiving personal care.

There were many other people who received welfare calls from London Care staff but this part of the service is not regulated and inspected by CQC.

There was a registered manager in post. 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 registered in March 2017 and this was therefore the first inspection of London Care (Poole). London Care had been providing care at the two of the three schemes since July 2016 and at the third scheme from November 2016. When London Care started to provide care and support, they were not registered to provide this service in Poole and it was managed from another of their registered locations in London. Therefore people in some of the extra care schemes in Poole had received care and support from London Care for almost one year. Newly registered services must be inspected by CQC within 12 months of the anniversary of registration. This inspection was brought forward because we were aware that people had been receiving services for nearly a year and because we had received concerns about how the service was run.

At this inspection we found nine breaches of the Health and Social Care Regulations 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009.

People’s medicines were not managed safely. People’s needs had not been properly assessed and planned for regarding the help they needed to take their medicines or apply prescribed creams. This meant that people were at risk of not receiving the correct medicine, in the correct quantity, at the correct time.

Systems to manage risk and ensure people were cared for in a safe way were ineffective. Risk assessments were not always fully completed or regularly reviewed. Some risks had not been identified as such and therefore no action had been taken to reduce or manage the risk. For example, some people had items of equipment such as hoists, bed rails and oxygen condensers. The service had not carried out risk assessments to ensure that the equipment was fitted correctly and worked safely. This meant that people’s safety and well-being was not always protected.

People told us staff were kind but there were many examples of poor practice and lack of understanding with regard to ensuring people's rights to privacy and dignity were recognised and respected. For example, male staff had been sent to females who had specified that they did not wish to receive personal care from males. Some people lacked mental capacity to make important decisions but staff had not ensured that the decisions that were made on people's behalf were in their best interests and were likely to have been what the person would have chosen for themselves.

Staff had completed training in essential areas such as moving and handling and health and safety. However, they did not always have the right skills and knowledge to meet people's specific needs. For example, they were caring for people with complex health conditions or learning disabilities but had not completed training in these areas.

There were not enough staff employed to meet people’s needs. People did not receive calls at the times they needed and visits were often cut short. Where people needed two staff to support them, they were not always both available at the correct time or sometimes only o