Two inspectors visited the offices of the provider for three days from the 12th ' 14th June 2012. We also visited the supported living project where London Care plc (Holloway) provided personal care to 38 people. The manager told us that approximately 600 people from the boroughs of Islington and Haringey were using the service in the community and at the supported living project. As part of the inspection we examined the personal files and care plans of 18 people who use the service. We spoke on the telephone and in person with 12 people who use the service and 10 care staff.We also spoke with the manager of the service and examined 14 staff personnel records. We looked at a range of other records relating to the provision of the service including records relating to safeguarding and complaints.
Each person receiving a service was assessed and an individual care plan developed with them outlining the support they would receive. Some care plans were not regularly reviewed or updated which meant that some people who use the service were at risk of receiving unsafe or inappropriate care as their care plans may not reflect their current needs. People who use the service told us that care staff promoted their dignity and privacy whilst supporting them with personal care. The majority of people who use the service told us that where they were supported with medication this was done sensitively and that they received their medication at the right times. People who used the service commented that their regular care worker 'was very good'. Another person commented that they were 'generally very satisfied with the service'. A third person told us that they were 'reasonably happy with the care provided'.
The provider had systems in place to provide care staff with safeguarding training and to log and monitor safeguarding concerns. We found that the outcome of safeguarding investigations was not always recorded and that people who use the service may be at risk of abuse because the provider had not obtained or followed the agreed plan as a result of an allegation of abuse. We also found that some care staff had not completed recent safeguarding training and others were not able to demonstrate a sound understanding of safeguarding issues and their responsibilities. We were concerned that this could put people who use the service at risk of abuse.
The provider had a significant number of vacancies for field assessor and care co-ordinator staff who develop and review care plans and supervise care staff. We were concerned that this could compromise the safety and wellbeing of people using the service. We found that care staff had limited training opportunities and were not regularly supervised which could have an impact upon the safety and wellbeing of people who use the service.
Since the last inspection in September 2011 the provider had notified the Care Quality Commission of incidents within the service. However, during this inspection we found that there were still some incidents that had not reported to us. When we looked at some records the provider maintained we could not be satisfied the recording systems in use were sufficient to ensure that care staff were performing their duties to an appropriate standard. We found that the provider did not have appropriate systems in place to gather, and evaluate information about the quality of the service provided that could be used to protect people and improve the service.