Background to this inspection
Updated
13 March 2021
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 one inspector. An Expert by Experience made calls to people who used the service and their families. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support services.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are 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 due to the COVID-19 pandemic. We needed to confirm with the provider whether they had any cases of COVID-19 at the service and discuss their infection control procedures before we entered the premises.
What we did before the inspection
We reviewed information we held about the service, including notifications of serious incidents the provider is required to tell us about.
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 this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection
We visited the service on 9 February 2021. We spoke with the registered manager, regional head of quality and regional director. We reviewed records of care and support for seven people who used the service, including records of medicines management. We looked at recruitment records for four staff members. We looked at records relating to the management of the service, including audits, service development plans, communications with staff and health and safety checks.
After the inspection
On 10 February 2021 we made calls to people who used the service and their families. We spoke with four people who used the service and four family members. We spoke with a contract monitoring officer at the local authority to discuss the provider’s performance and contract monitoring arrangements, and made calls to four care workers.
We asked the provider to send us some other information which we reviewed after the inspection to reduce the time that we spent on site. This included records of governance reviews, data from the provider’s electronic care management (ECM) system and health and safety checks.
Updated
13 March 2021
About the service
London Care (Lime Tree House) is an extra care service. People using the service lived in rented flats in a purpose-built building. At the time of our inspection there were 38 people receiving personal care at this service.
The service includes the Southwark Night Owl service. This provides care and support to people living in their own homes in the London Borough of Southwark who require support with personal care tasks at night. There were 8 people using this service at the time of this inspection.
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
People told us they were happy with the service they received from the provider. A person told us “The staff are caring and do a good job with a smile.” People were safeguarded from abuse and poor treatment and there were suitable processes to respond to safeguarding concerns.
The provider had improved the delivery of the night owl service. People told us that staff arrived on time and were reliable. There was now a system in place to ensure that calls took place as planned at night. Staffing levels were sufficient to meet people’s needs and staff were safely recruited. Medicines were safely managed, with appropriate checks to ensure that people received their medicines as planned.
The provider had put measures in place to protect people from the COVID-19 pandemic. This included ensuring staff used personal protective equipment correctly and had training in this, and there was enhanced cleaning within the service. Staff and residents were tested regularly and were supported to be vaccinated against the disease. Risks to people’s wellbeing were assessed and the provider took appropriate measures to mitigate these risks.
People told us they knew how to make complaints and ask for changes to their service, and the provider checked that complaints were addressed in line with their complaints policy.
There were improved systems of governance. A monitoring system was used to ensure complaints, incidents and accidents were responded to appropriately. There were regular checks on the quality of people’s care, including checking records of care and medicines management and speaking with people about the quality of their service. Staff understood their responsibilities and key duties were allocated and checked. Managers acted promptly to address staff concerns and support the staff team.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was requires improvement (published 9 December 2019).
Why we inspected
We carried out an unannounced comprehensive inspection of this service between 26 September and 7 October 2019. Breaches of legal requirements were found and we issued a warning notice regarding good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance and the handling of complaints.
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, Responsive and Well-led which contain those requirements.
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 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 Care (Lime Tree House) on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.