London Care (Westminster)

Updated 4 October 2022

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 Health and Social Care Act 2008.

Inspection team

The inspection was conducted by two inspectors and one Expert 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 houses and flats and specialist housing.

Registered Manager

The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was not a registered manager in post and the provider had commenced recruitment for a new manager.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed information we held about the service, including the last inspection report and notifications of serious events the provider is required to inform us of. We spoke with representatives from the home care commissioning, home care contracts monitoring and safeguarding teams at the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

Inspection activity commenced remotely on 30 June 2022 when we requested a range of information to be sent to us electronically, which included policies and procedures for safeguarding adults and supporting people with their medicines, infection prevention and control documents and electronic call monitoring (ECM) data. We carried out a site visit to the office location on 5 July 2022 where we spoke with two care workers, a care coordinator, the care manager, the regional director and the regional head of quality and governance. We looked at eight care plans and quality monitoring documents such as ‘spot check visits’ records. We looked at five staff files to check recruitment, training, supervision and appraisal.

Following the visit to the office location, we continued to seek clarification from the provider to validate evidence we found. We spoke by telephone on 8 July 2022 to six people who used the service and two relatives for their views about the quality of the service. We held a remotely conducted feedback session with the provider on 26 July 2022. We requested the contact details for further members of the care staff team and relatives of people who used the service in order to widen the scope of information we had already gathered. We concluded our telephone calls to an additional four staff members and three relatives on 15 August 2022. We spoke again with the manager of the local authority home care commissioning team.

Updated 4 October 2022

About the service

London Care Westminster is a domiciliary care agency which provides personal care to people living in their own homes. At the time of our inspection there were approximately 220 people using the service. 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.

People’s experience of using this service

People told us they were happy with the care and support they received, although on occasions staff arrived "a little late". This feedback reflected our findings which showed staff were frequently not provided with the travel time between visits that they needed.

People's needs were assessed and planned for. However, we found some people were placed at risk by the provider when they did not receive care from two staff members together, as the provider was not following the person's agreed care plan.

People told us they felt safe and comfortable with their care workers. People were supported by safely recruited staff who received appropriate training to carry out their duties.

People felt assured that staff understood how to meet their personal care needs and support them to take their medicines, if this was part of their care plan. People commented on how staff worked in a hygienic way and took suitable action to protect them from the risk of infection.

People and their representatives were asked for their views about the quality of their care and support and they had developed positive relationships with their care workers and the office based staff team.

People were communicated with and consulted in a variety of ways including surveys, telephone monitoring calls and 'spot check' visits from supervisors and managers.

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 good (published 6 July 2021).

Why we inspected

The inspection was prompted in part due to concerns received about people's safety and the management

of the service. We received information of concern in relation to whether people received scheduled visits from care staff in line with their agreed care plans, and whether some members of the care staff team had completed their annual mandatory refresher training to enable them to provide safe care and support. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe and well-led only.

You can see what action we have asked the provider to take at the end of this full report.

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 changed from good to requires improvement. 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 Westminster on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.