7 July 2023
During a routine inspection
About the service
Lotus Community Care Service provides supported living services to people with a learning disability or autism and people with mental health needs. At the time of our inspection the provider operated 2 of these services in the London Borough of Ealing. Staff provided 24-hour support in each service. One was a house where 4 people lived, the other was a house where up to 5 people lived. There were 3 people living there at the time of our 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. Only 4 adults were receiving personal care at the time of our inspection.
People’s experience of using this service and what we found
Right Support
The use of surveillance in people’s homes had not been arranged according to relevant codes of practice and legislation. People were supported to have choice and control in their lives and staff supported them to promote this. However, the policies and systems in the service did not always support this practice as it was not always clear how people's mental capacity was assessed and decisions were taken in their best interests.
The provider had not always implemented appropriate recruitment procedures to ensure only suitable staff were recruited to work at the service.
People received care and support that met their needs. Staff supported people with their medicines safely. The service gave people care and support in a safe, clean, and maintained environments that met their needs. People were able to personalise their rooms.
Right Culture
The provider's monitoring processes were not always effective in helping to ensure people consistently received good quality care and support that always promoted people’s rights.
People and those important to them, including advocates, were involved in planning their care. People received consistent care from staff with whom they could develop relationships of trust.
The provider ensured staff had supervision and support to help them in their roles.
Right Care
The service had enough staff to keep people safe.
Staff had training on how to recognise and report abuse and they knew how to apply it. Staff attended training and completed an induction to help them support people.
The service worked with other agencies to support people to experience a smooth transition to the service. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that promoted their independence and daily living.
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 7 June 2022) and there were breaches of regulation. 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 the provider remained in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 21 April 2022. 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, recruitment, care planning 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, Effective, Responsive 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 remained 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 Lotus Community Care Service on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to recruitment, to supporting people in line with the principles of the Mental Capacity Act 2005, promoting people’s rights and good governance at this inspection. We have made a recommendation about person-centred support planning.
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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.