Archived: London Care Holloway

Updated 16 August 2019

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

This inspection was carried out by two inspectors, one medicines inspector, and three

Experts by Experience. An Expert-by-Experience is a person who has personal experience of using or caring

for someone who uses this type of care service. Before our visit to the head office, we spoke with 17 people who use the service and 17 relatives.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

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 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We reviewed information we had received about the service since the last inspection such as statutory notifications. A statutory notification is information about important events, which the provider is required to send us by law. We used this information as part of our planning. We used all of this information to plan our inspection.

During the inspection

We spoke with the regional director, the regional manager, the registered manager, one care coordinator and the calls monitoring officer. We reviewed a range of records. This included 21 people’s care records and multiple medication records. We looked at 10 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We received feedback from 15 care staff. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 16 August 2019

About the service

London Care (Holloway) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and specialist housing. It provides a service to people living with dementia, learning disabilities or autistic spectrum disorder as well as physical disability and sensory impairment. There were approximately 186 people using the service at the time of the inspection. All of them were receiving personal care. This is help with tasks related to personal hygiene and eating. The provision of personal care is regulated by the Care Quality Commission.

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

Since the last inspection the service has made improvements in several areas of the service provision. This included improved risk assessment and management, increased continuity of care to people by the same staff and dealing with complaints. The provider has also introduced a new online care planning system which helped staff to provide responsive, individualised and considerate care.

Some aspects of the service provision needed further improvement, and these were related to the management of medicines, communication around care visit schedules and the customer service. However, overall people and their relatives told us they were satisfied with the service they received.

People felt safe when cared for by staff. Staff were recruited safely and the provider’s safeguarding polices and procedure helped to protect people from abuse. Risk to people’s health and wellbeing had been assessed and managed. Staff were provided with information on how to protect people from harm. This included various risk control measures relating to people’s environment, specific health conditions and infection control. The managers also regularly monitored, analysed and learnt from accidents and incidents that occurred within the service. There were enough staff deployed to support people. The managers were working towards ensuring that staff attendance had been monitored and punctuality improved.

People’s needs were assessed and people’s care plans included information gathered during the assessment meeting. The provider’s new online care planning system enabled information about people’s care to be updated in a real time and with no delay. Therefore, staff could have access to up to date information about people’s care needs and how to best support them. Staff were sufficiently trained. A range of managerial staff checks, such as spot checks and one to one supervision, helped to ensure staff provided care that was safe, effective and kind. 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. Staff supported people to have their needs met. This included providing a nutritious and sufficient diet, having access to external health professionals when needed and other needs around people’s individual health conditions, religious, cultural and personal requirements.

Overall people thought staff were kind and compassionate. All people and relatives spoke positively about their regular care staff. People felt cared for and supported as required. Some people and relatives said it was more difficult to create friendly relationships with staff who supported them when their usual care staff was not able to visit. People were supported to sustain their independence as staff encouraged people to do things for themselves as much as possible. People said staff were considerate, respected their privacy and ensured their dignity was protected when receiving care.

Most people and relatives said the service had dealt with their complaints promptly and to people’s satisfaction.

The managers knew their roles and responsibilities related to the managing of the regulated activity. There were quality monitoring systems in place to help to monitor and improve the service delivery. The managers were ambitious and driven to ensure identified gaps in the service provision were addressed. The general feedback from people, relatives and staff was positive. Improvements since the last inspection were observed by people and relatives and we found that overall satisfaction with the service provision had improved.

We have made two recommendations about the management of medicines and aspects of customer 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 last rating for this service was requires improvement (published 12 July 2018) and there was a breach of Regulation 12. 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 improvements had been made and the provider was no longer in breach of Regulation 12.

Why we inspected: This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for London Care Holloway 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.