Background to this inspection
Updated
12 February 2021
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
The inspection was carried out by one inspector and two 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with CQC. 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 management team would be in the office to support the inspection.
What we did before the inspection
We reviewed the information we held about the service. This included notifications of significant incidents reported to us and the previous inspection report. We sought feedback from local commissioners. The provider was not asked to complete a provider information return prior to this inspection. We used all of this information to plan our inspection.
During the inspection
We spoke with the registered manager, the regional manager and the quality lead. We spoke with 34 people who used the service and their relatives. We spoke with 21 care workers. We reviewed a range of records, including 10 people's care records and medicines records. We looked at five staff files and various records relating to the running of the service, including safeguarding and quality assurance records. We reviewed the electronic call monitoring records for the service over a six-week period.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
12 February 2021
About the service
London Care-Crayford is a domiciliary care agency. It provides personal care to people living in their own homes. At the time of the inspection, 270 people were using the service.
Not everyone who used the service received personal care. Care Quality Commission (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
People benefitted from an improved service. However, some staff were not provided with enough time to travel between calls at evenings and weekends. We have made a recommendation about the deployment of staff.
People were kept safe from avoidable harm and were cared for by staff who were well-trained and understood how to protect them from abuse. Staff were knowledgeable about safeguarding vulnerable people and knew how to raise any concerns.
Risks to people’s safety had been assessed and documented and staff understood their roles keeping people safe.
People received support with their medicines, from staff who were appropriately trained and assessed as competent in this area.
People were overwhelmingly positive about the care they received from a regular staff team who knew people well. Staff supported people in a caring and dignified way, and promoted people’s independence.
Staff understood their responsibilities for good record-keeping and used the provider’s electronic record keeping system, which managers monitored in real-time, reducing the risk of errors.
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 16 January 2020) and there were multiple breaches of regulation. The provider had 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 regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 29 May 2019. Breaches of legal requirements were found and a Warning Notice was served in relation to Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider completed an action plan after the inspection to show what they would do and by when to improve their complaints handling, the effective deployment of staff, and the governance of the service.
We carried out an announced targeted inspection of this service on 05 December 2019 to check whether the Warning Notice we had served at the last inspection had been met. We found that the service was still in breach of that regulation.
We undertook this focused inspection to check they had followed their action plan and to confirm whether they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive 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 improved to Good. 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-Crayford 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.