We carried out a review of the data available to us about London on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about London, you can give feedback on this service.
London is the only branch of The Social Care Ltd, a domiciliary care agency located in the London Borough of Ealing. They provide personal care and support to people living in their own homes. At the time of our inspection, there were 99 people using the service. The agency cared mostly for older people, adults with disabilities and people with mental health needs.
Everyone using the service at the time of our inspection received support with personal care. This is not always the case for care agencies. 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
People were happy with the service. They felt well supported and had the same regular care workers. Care workers arrived on time.
People and their relatives felt care workers had the right skills to provide safe care.
Medicines were managed in a safe way.
The risks to people's safety and wellbeing had been assessed, were monitored and planned for.
The provider responded appropriately to complaints, incidents and accidents. They had effective systems for monitoring and improving the quality of the service.
There was a suitable management structure in place. There were regular meetings and information sharing for staff to make sure they were aware of their roles and responsibilities.
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 rating at the last inspection was requires improvement (published 15 July 2021). 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 improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out our last inspection of this service on 29 June 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
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 has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for London on our website at www.cqc.org.uk.
This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and phone calls to engage with people using the service as part of this performance review and assessment.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
London is the only branch of The Social Care Ltd, a domiciliary care agency located in the London Borough of Ealing. They provide personal care and support to people living in their own homes. At the time of our inspection, there were 118 people using the service. The agency cared mostly for older people, adults with disabilities and people with mental health needs.
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.
People’s experience of using this service and what we found
People's medicines were not always managed in a safe way. The risks relating to medicines had not been fully assessed, information about people's medicines needs were not clear and staff were not always recording when they had supported people to take their medicines. This was partly due to confusion over guidance from commissioners. However, there was a risk people were not receiving medicines safely because this support was not properly planned or monitored.
The provider had not always maintained clear records to evidence they were effectively monitoring the quality of the service and mitigating risk. For example, there were no records to show the staff had been assessed as competent in administering medicines or moving people safely. Nor were there records of their induction when they started working at the service. The provider had not always recorded assessments of the risks within people's home environment. This meant they may not always have taken steps to reduce these risks.
People told us they were happy with the care they received and had the same familiar care workers who they liked and had good relationships with. People were involved in planning their care. Their needs were regularly reviewed, and the agency had liaised with others (such as healthcare professionals and commissioners) when they identified a change in someone's needs.
The staff felt well supported and told us they had the information and training they needed to carry out their roles. There were appropriate systems for recruiting staff to make sure they were suitable.
The agency had an experienced management team who worked closely with the staff to monitor people's needs. They responded appropriately to complaints, incidents, accidents and other adverse events to make sure these were dealt with and could be learnt from. People using the service, family members and staff told us they felt managers were approachable and helpful.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The rating at the last inspection was good (Published 6 February 2019).
Why we inspected
This was a planned inspection based on the previous rating.
We undertook this focused inspection to look at the Key Questions of Safe, Responsive and Well-led. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for London on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safe care and treatment and 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.
The Social Care - London Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a personal service to both older adults and younger disabled adults. At the time of our inspection 12 people were using the service.
The service has 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.
Staff were trained to protect people from abuse and knew how to report suspected abuse. The registered manager understood their responsibilities to respond to allegations of abuse appropriately. Risks to people were assessed and management plans put in place to mitigate identified risks. Staff were sufficient and adequately deployed to support people with their needs. People received the support they needed to manage their medicines safely. Staff followed procedures to minimise the risk of infection. The service had systems in place to report incidents and accidents and staff knew about them. The registered manager reviewed incidents and took action to prevent them from happening again.
Needs assessments were conducted involving people, their relatives and other professionals where necessary. Care plans were developed to meet people’s needs and requirements. Staff were supported to do their jobs through regular training and supervision. Staff supported people to meet their nutritional needs and requirements. People were supported to access the health care services they needed to maintain their health. The service had systems in place to ensure people received well-coordinated care.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff and the registered manager understood their roles and responsibilities under the Mental Capacity Act (MCA) 2005. Staff involved people in their care delivery and ensured people consented before care was delivered.
People told us that staff treated them with kindness. People’s needs, preferences and choices were considered when planning their care. Staff respected people’s dignity and privacy. People were encouraged to maintain their independence as much as possible.
Staff supported people in a way which met their individual needs. Care plans were reviewed regularly to reflect people’s current needs. Staff respected people’s cultural, religious and belief systems. At the time of our visit no one was receiving end of life care. Training record showed that some members of staff had received end of life training and the registered manager told us they would work closely with other professionals to meet people’s need.
People knew how to report their concerns or complaints about the service. The registered manager knew to address complaints in line with their procedure. The quality of the service was regularly assessed and monitored through spot checks and audits.
The service had a registered manager who complied with the requirements of their registration. The service had a business development strategy and a business continuity plan in place which set out how the service would develop, achieve positive outcomes for people and manage unforeseeable situations. The service worked in partnership with the local authority and other local organisations to develop the service and meet people’s needs.