Archived: London Care (Wembley)

We used a number of different methods to help us understand the experiences of people using the service. We looked at records. We spoke with thirteen people who used the service and their relatives, the interim manager and the regional manager. We also read feedback from relatives.

In this report, the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

Below is a summary of what we found. The summary describes what people using the service and staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People who used the service had support plans and risk assessments in place.

We saw there were recruitment and selection procedures in place. We found appropriate checks had been undertaken before staff began work; however there were instances in which we were unable to locate documentation which showed appropriate checks had been undertaken to ensure staff were not barred from working with vulnerable people.

Staff were trained in areas of relevance to their job roles.

Is the service effective?

We looked at ten care plans and saw that people's needs were assessed and their care and support was delivered in line with their individual care plans. We found risk assessments had been completed for each person and were relevant to people’s needs and requirements.

We found there were instances where care and treatment was not planned and delivered in a way that was intended to ensure people's safety and welfare. There were instances in which care workers turned up late and people were not informed of which care workers would be coming to their homes especially at the weekends.

Is the service caring?

People who used the service and their relatives spoke positively about the care workers and told us they were treated with respect and dignity. They told us “it is absolutely the best care”, “they are smashing” and “they are very helpful.”

Is the service responsive?

When speaking with people, they were aware of how to make complaint. One person who used the service told us they had spoken to the management about a concern and they had been “very obliging” and “the office staff are very good and do a very good job.”

We found care plans were up to date and had been reviewed and updated when people's needs had changed. When speaking with staff they had a good understanding people’s needs. They told us they were aware of peoples care plans and regularly checked to see if people’s needs had changed.

Is the service well-led?

At the time of our inspection, the registered manager had left and an interim manager was overseeing the service. The regional manager told us they will be looking to recruit a new registered manager promptly.

The service had an effective system to regularly assess and monitor the quality of service that people received. We found quality assurance questionnaires had been sent out to people who used the service and also saw evidence of feedback received via telephone monitoring.

During that inspection we found that a significant proportion of staff had not received staff supervisions and yearly appraisals. We also found that the provider had not held team meetings for a significant period of time.

At our last inspection we also found that the provider failed to notify the CQC in relation to a safeguarding incident.

During this follow up inspection we spoke with six members of staff. All staff we spoke with were positive about working for the provider and said that they felt supported by the provider.

During this inspection, we focused on whether the provider had met the compliance actions in respect of Outcome 14 supporting workers, Regulation 23 (HSCA 2008 Regulated Activities) Regulations 2010 and Outcome 20 Notification of other incidents, Regulation 18 (HSCA 2008 Regulated Activities) Regulations 2010 following our compliance actions.

We spoke with nine members of staff, eight of whom were care staff. All care staff were aware of the importance of treating people with respect and ensuring that people were always given a choice. One member of staff we spoke with told us that it was important for people to be as independent as possible whilst being supported.

The care of people had been assessed and care plans prepared. These were signed by people or their representatives. People we spoke with were positive about staff and indicated that care staff were reliable and competent.

At the last inspection in January 2013, we highlighted concerns about lack of staff supervisions. During this inspection, we were told that not all staff had received their supervisions. The documentation provided to us demonstrated that some progress had recently been made. During this inspection we were also concerned by the lack of appraisals for staff. We viewed training records and noted that a significant number of staff were due their safeguarding and moving and handling refresher training.

We observed that the provider had a system to assess and monitor the quality of service that people receive.

People had care plans in place and were involved in the assessment and care planning process. They told us that they had an up to date care plan in their home and carers referred to this. People told us that they felt 'safe' with care workers and concerns raised had been dealt with swiftly and satisfactorily.

People told us that they had good relationship with staff and valued the consistency of regular staff. Comments included, “I have known my carers for over five years that makes it easy.”People told us that staff had the appropriate skills to do the work. One person’s comment included, “they have regular training.”

People told us that they had been consulted about the treatment and care received. Comments included, “they come around and reassess my needs every year.”

We noticed that supervisions did not happen as frequently as stated in the agencies supervision procedure. The manager and senior staff spoken with acknowledged that the lack of regular supervisions of care workers may have an impact on the care and support provided.

Regular telephone and postal surveys ensured that the quality of care and support was monitored regularly.