Archived: Cera - London

Updated 25 August 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

Two inspectors carried out this inspection, and an Expert by Experience made calls to people using the service and their relatives, to gain feedback on the service offered. 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 houses and flats.

The service did not currently have a manager registered with the Care Quality Commission, and they had not yet applied for the role. A registered manager 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 it is a domiciliary care service and we needed to be sure that the manager would be in the office to support the inspection.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

Before the inspection, we checked for any notifications made to us by the provider and the information we held on our database about the service and provider. Statutory notifications are pieces of information about important events which took place at the service, such as safeguarding incidents, which the provider is required to send to us by law.

We also liaised with the local authority due to safeguarding concerns. We used all of this information to plan our inspection.

During the inspection

We spoke with seven members of care staff, a care co-ordinator, two care quality lead staff, the quality manager and the manager of the service who is registered with CQC to manage another branch of the service in London.

We also looked at four staff recruitment records, seven care records, and the computerised care records application the staff use to log into people’s homes and record the care given.

We reviewed medicine administration records (MAR) on-line, training records and supervision and appraisal documentation.

Following the inspection office visit, we reviewed MAR audits, the complaints log, and the safeguarding log for the last six months.

We spoke with five people who use the service and 11 family carers to get their feedback on the service.

We also received feedback from two health and social care professionals.

Updated 25 August 2021

About the service

Cera London is a domiciliary care agency. It provides personal care to a range of adults living in their own homes with a broad range of physical, mental health and learning disability needs.

Not everyone who used the service received personal care. 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. At the time of the inspection there were 81 people receiving a service that is regulated by CQC.

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

Most people and their relatives told us staff were kind and caring. However, issues of lateness, difficulties with contacting office staff, and the management of complaints were identified as issues for a significant number of people and their relatives.

The service had undergone significant changes in the last 18 months as the provider had acquired and integrated another local domiciliary care organisation. This meant a number of staff and people using the service were integrated into the new branch and management structure.

Over the past 18 months there had been significant changes in management of the service at a regional director and branch level. This had impacted significantly on the quality of care and management of the service. Although a new manager was in post and had recently acted quickly to address immediate concerns, we still found serious concerns with the management of the service. The new manager was expected to manage two domiciliary care branches despite the issues with quality we identified at this inspection.

Risk assessments did not always provide staff with suitable guidance to keep people safe. Audits of medicines had not always taken place in a timely manner and this impacted on actions to remedy errors. We were not confident that all medicines were safely managed.

Whilst the provider had systems in place to check the quality of care, we found remedial action had not always taken place. We were not confident that all complaints were followed up and resolved.

Care plans were person centred and the majority portrayed a holistic picture of people’s lives, their needs and their network of support.

Supervision, training and spot checks of staff took place.

Staff recruitment was safe, and appropriate checks were taken prior to staff starting work.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was last inspected under the name of Waterloo Care Services (provider Cera Care) and rated good. The report was published on 2 December 2019.

Since the last inspection the provider has taken ownership and integrated another existing domiciliary care service. This means some staff and people from that service have been integrated and receive care from the new service, now called Cera London.

The inspection was prompted in part due to concerns received about safeguarding allegations, and lack of consistency in the management of the service. A decision was made for us to inspect and examine those risks.

At this inspection we found breaches of the regulations in relation to the governance of the service and the safe care and treatment of people. We have also made a recommendation in relation to compliance with use of PPE.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.