London Homecare Ltd

This service is a domiciliary care agency and is based in the London Borough of Havering. The service provides personal care to adults in their own homes. 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.

At the time of our inspection, the service provided personal care to nine people, primarily older people.

People’s experience of using this service

Risks were identified and were assessed to ensure people received safe care. Medicines were being managed safely. Pre-employment checks had been carried out to ensure staff were suitable to support people. People and relatives told us people felt safe when receiving support from staff and staff were aware of how to safeguard people from abuse. There were appropriate numbers of staff to support people when required. Systems were in place to prevent and minimise the spread of infections when supporting people. Systems were in place to learn from lessons following accident and incidents.

Staff had completed essential training to perform their roles effectively and felt supported in 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 received care from staff who were caring and had a good relationship with them. Staff respected people’s privacy and dignity. People were encouraged to be independent and to carry out tasks without support.

People received person-centred care. Care plans had been reviewed regularly to ensure they were accurate. Systems were in place to manage complaints and people’s communication needs were met.

Quality assurance systems were in place to identify shortfalls to ensure there was a culture of continuous improvement. Feedback was sought from people and staff and this was used to make improvements to the service.

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

Rating at last inspection

The previous rating for this service was requires improvement (published 27 May 2020) and there were multiple breaches of regulation. We issued a warning notice for a breach of Regulation 17 (Good Governance). There were also requirement notices issued for Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment) and Regulation 19 (Fit and proper persons) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We carried out a targeted inspection on 22 September 2020 (published 15 October 2020) to check if the service was compliant with the warning notice we served for Regulation 17 (Good Governance). We found the service was compliant with the warning notice.

Why we inspected

This was a planned inspection based on the rating of the last inspection.

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.

This service is a domiciliary care agency and is based in the London Borough of Havering. The service provides personal care to adults in their own homes. 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.

At the time of our inspection, the service provided personal care to six people.

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

At our previous inspection of this service on 7 February 2020, we found risk assessments were not robust and did not identify risks to people around their health conditions. Robust pre-employment checks had not been carried out when recruiting staff. At this inspection, we found improvements had been made. People’s risks were assessed, control measures were in place to mitigate risks and pre-employment checks were carried out robustly.

At the previous inspection, we found mental capacity assessments were not being completed for people that may not have capacity to make specific decisions. Consent had not been sought from people prior to delivering support and care. At this inspection, we found 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.

At the previous inspection, we found effective quality assurance systems were not in place to identify the shortfalls we found during the inspection. At this inspection, improvements had been made and there were effective quality assurance systems in place, which included auditing risk assessments and consent forms.

The registered manager had completed spot checks on people using the service. There were systems in place to ensure ongoing spot checks were completed and recorded regularly.

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

Rating at last inspection

The previous rating for this service was requires improvement (published 20 March 2020) and there were multiple breaches of regulation. We issued a warning notice for a breach of Regulation 17 (Good Governance). There were also requirement notices issued for Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment) and Regulation 19 (Fit and proper persons) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, enough improvement had been made and the service was compliant with the warning notice and requirement notices issued.

Why we inspected

We undertook this targeted inspection to check whether the warning and requirement notices we previously served had been met. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on warning and requirement notices. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

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.

This service is a domiciliary care agency and is based in the London Borough of Havering. CQC only inspects where people receive personal care. The service provided personal care to adults in their own homes. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

At the time of our inspection, the service provided personal care to six people.

People’s experience of using this service

The provider was failing to ensure the service was meeting regulations. Audits had not been carried out on medicines to ensure medicines were being managed safely. Sufficient risk assessments were not in place to ensure people received safe care at all times. Pre-employment checks had not been carried out to ensure staff were safe to support people.

Regular supervisions had not been carried out to ensure staff were supported to carry out their roles. We made a recommendation in this area.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

There was no system in place to evidence that people had been involved in the decisions about the support they received. People’s communication abilities had not been included in their care plans. We made a recommendation in this area.

Robust pre-assessments systems were not in place to ensure people received support in a person-centred way. Quality assurance systems were not in place to identify shortfalls and take prompt action to ensure people always received safe care.

People told us they were safe when supported by staff. People told us staff were punctual and systems were in place to monitor time keeping. Systems were in place for infection control and to learn from lessons following incidents.

Staff had been trained in key areas to perform their role effectively. People received care from staff who were kind and compassionate. Staff treated people with dignity and respected their privacy. Staff had developed positive relationships with the people they supported. They understood people’s needs, preferences, and what was important to them.

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

Rating at last inspection

This service was registered with us on 11 February 2019 and this was the first inspection.

Why we inspected

This was a planned inspection based on when the service started to provide the regulated activity of personal care. The service registered with the CQC on 11 February 2019 and started to provide the regulated activity of personal care on September 2019.

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

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to risk assessments, pre-employment checks, need for consent and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will discuss with the provider prior to this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.