London Care (East London)

About the service

London Care (East London) is a domiciliary care agency providing personal care. The service provides support to people living in their own home. At the time of our inspection there were 280 people using the service.

People’s experience of using this service and what we found

Right Support

The service made reasonable adjustments for people so they could be fully involved in discussions about how they received support, including support to travel wherever they needed to go. The provider was responsive to people's needs, care plans were personalised and outlined detailed support for staff to be confident in delivering safe care. People were able to make a complaint and were confident this would be addressed. People told us they had care plans and were involved in decisions about their care and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

Right Culture

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. People were supported by staff who were well trained and supported in their role. People told us that care workers were good at their jobs. People and relatives told us the managers were good and the service was well run. Checks about the quality of care were carried out on a regular basis. This meant that any concerns could be dealt with in a timely manner.

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 05 May 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

The inspection was prompted by a review of the information we had about the service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

London Care (East London) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of the inspection the agency was providing personal care to 540 people.

Not everyone who used the service received personal care. The 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

The provider’s recruitment checks and records needed improvement to ensure appointed staff were safe and suitable to work in the caring profession. The provider took action to address this during the inspection.

People’s care records did not always contain information about when they should receive medicine on an ‘as required’ basis. We made a recommendation about this. People told us medicines were administered safely and staff told us they had received relevant medicines training.

The provider needed to make further improvements regarding medicine administration and audits. The provider’s recent upward trend in timely care visits needed to be sustained. The provider told us the pressures of the coronavirus pandemic meant that these improvements were still being embedded. Since our last inspection, the provider had made improvements to care delivery to ensure people received care from a consistent care staff team. People told us they felt safe and care workers were friendly.

People told us the managers were accessible and felt any concerns would be acted upon. Staff told us the management was good and the registered manager reported they worked in partnership with the local authority and other external agencies to improve care delivery.

The provider had put infection control measures in place to minimise the risk of the spread of infection. People told us staff wore personal protective equipment (PPE) when they visited their homes and the provider told us they had enough PPE in stock.

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 last rating for this service was requires improvement (published 23 April 2020) and there were two breaches of the regulations around staffing levels and good governance.

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 an announced comprehensive inspection of this service on 9 March 2020. Breaches of legal requirements were identified. The provider completed an action plan after the last inspection to show what they would do and by when to improve staffing 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.

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 remained the same and 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 Care (East London) 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.

London Care (East London) is a domiciliary care agency providing personal care to 556 people at the time of inspection. The service operates across four London boroughs with two registered managers taking responsibility for different areas.

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 told us that punctuality was inconsistent, particularly at weekends. We identified shortfalls in how care calls for people who needed two staff to support them were planned and fulfilled. We also found some shortfalls in governance and records about people’s care did not always accurately reflect their needs. The service had identified these issues and a new care planning system had been introduced and was in the process of being embedded. However, more action was required to ensure the legal requirements were met.

People said they felt safe when staff supported them and staff administered people’s medicines in line with best practice. There was a system to document and monitor any incidents in order to learn from them. People said staff followed best practice in relation to infection control and staff were knowledgeable in this area.

People’s feedback about the competence of staff was positive and staff were given the right training for their roles. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People said that where staff prepared food for them, they prepared it in an appetising manner and people’s dietary needs were met. Staff worked with other organisations and made referrals to healthcare professionals where required.

People described positive relationships with staff and staff were committed to supporting people. Care was planned around people’s diversity and we saw examples of people being supported to practice their faiths. Staff encouraged people to maintain their independence and do tasks for themselves where they could. People received care which was respectful of their privacy and promoted their dignity.

People said they received personalised care which met their needs, but care plans did not always reflect this. People’s communication needs were met and care plans informed staff about people’s wishes regarding end of life care. We identified informal complaints were not always documented and responded to. We made a recommendation about complaints.

Staff felt supported by management and there were systems in place to recognise and reward best practice. The service worked with external organisations and shared information with relatives and healthcare professionals openly when there had been incidents. The provider had notified CQC of events and incidents when they were required to do so.

Rating at last inspection

The last rating for this service was good (published 11 May 2019).

Why we inspected

The inspection was prompted in part due to concerns received about call punctuality and attendance. The service had increased in size significantly since our last inspection which indicated an increase in risk. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

Enforcement

We have identified breaches in relation to staff deployment and care records.

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.

People’s experience of using this service:

• People told us they felt safe. People were protected against avoidable harm, abuse, neglect and discrimination.

• People's risks were captured, and plans were put in place to mitigate the risks.

• People's likes and dislikes were assessed and people’s needs were being met in a personalised way.

• Feedback from people about the care and their care workers was positive.

• People told us the service was caring.

• People's care was person-centred. The care was designed to ensure people's independence was encouraged.

• People were involved in the care planning and review of their care.

• The service had a stable management structure.

• The provider had implemented systems to ensure they continuously measured the quality of the service.

•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.

• The service met the characteristics for a rating of "good" in all the key questions we inspected. Therefore, our overall rating for the service after this inspection was "good".

Rating at last inspection:

•This was the first inspection for the service since its registration in April 2018.

Why we inspected:

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

• We will continue to monitor the service through the information we receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk