Archived: London Care (South London)

Updated 8 February 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 2 and 4 November 2015 and was announced. The provider was given 48 hours’ notice because the location provides domiciliary care service and we needed to be sure they were available to give us information during the inspection. The inspection was carried out by one inspector and an expert by experience (ExE). An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to the inspection we reviewed information we held about the service including statutory notifications the service had sent us. We also spoke with a health care professional to ascertain their views of the service and how it is manager. During the inspection we spoke with five care workers, one operations co-ordinator, the manager and the area manager. We reviewed 12 care plans, seven staff files, six MARS (medicine administration recording sheets) and policies and procedures relating to medicines, complaints and safeguarding. We also looked at records relating to the management of the service.

After the inspection we spoke with six people and their relatives.

Updated 8 February 2016

The inspection was carried out on 2 and 4 November 2015 and was announced.

The service is registered to provide and personal care to people in their own homes. At the time of the inspection there were 580 people using the service ranging from people who received one visit per week to people who received visits four times a day. London Care (South London) provides care and support to people in Greenwich, Lewisham and Southwark.

At the time of the inspection there was a manager in place who had undertaken the Registered Manager interview with the commission. 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.

The service was registered on 4 September 2014 and had not previously been inspected.

People were at significant risk of harm from poor medicine management. Medicines were not always recorded correctly, for example people’s names, known allergies, name of medicine, date, dosage, route and frequency were not always documented to ensure safe medicine management.

Medicine audits were not always completed for people. Audits that were completed were inaccurate and did not take the necessary steps to rectify or mitigate against identified errors.

Staff did not receive ongoing comprehensive training in safe medicine management. The manager confirmed the training did not meet the training needs of care workers to safely manage medicine.

People were not always protected against known risks. Risk assessments were not always comprehensive and did not give clear guidance for staff to respond to known risks.

People were supported by staff who had been trained and had clear knowledge on how to identify signs of abuse and the organisation’s safeguarding procedures.

People felt safe receiving care and support from staff. People told us staff were kind and compassionate when delivering care and treated them with dignity and respect at all times. People were actively encouraged to maintain their independence.

People were supported to access enough food and drink to meet their dietary needs, which were documented in their care plan.

Staff had sound knowledge on how to minimise the risk of social isolation to people and actively worked in conjunction with the manager and relatives.

People could raise concerns and complaints without fear. People and staff were aware of the correct procedures to follow to make a complaint and felt they would be listened to and action taken where appropriate. Records confirmed complaints were thoroughly investigated and action taken.

A new care plan system was being introduced to replace current care plans that were not always comprehensive and did not always record people’s changing needs.

The manager questions the quality of the service regularly however did not always carry out audits to identify areas of improvement or areas they did well in.

During this inspection we identified three number of breaches of the Health and Social Care Act 2008

(Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of this report.