Lambeth Branch

This inspection took place on 8 May 2018 and was announced. 48 hours before the inspection we contacted the service to let them know that we will be coming to inspect them. We wanted to make sure that someone would be available on the day of inspection.

At the last inspection on 13 and 21 April 2016 the service was rated GOOD. At this inspection we found the service remained Good, with Requires Improvement in well-led.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People's care records had not always addressed the support people required to stay safe. Information was missing on the assistance people required to minimise risks. Care plans were not always fully completed and information about people's health conditions was missing. We have made recommendations about this.

Staff had not completed appropriate training on the Mental Capacity Act (2005) to ensure they had the required knowledge and skills to support people effectively. We have made a recommendation about this.

People and their relatives told us that staff were regularly late for their shifts and there were occasions when staff had missed the visits. We have made a recommendation about this.

Quality assurance systems used were not always affective and therefore we recommended the provide to review their auditing processes to ensure that people's care records were maintained as necessary.

There were adult safeguarding procedures in place and these were followed by staff to support people from potential harm and abuse. People received their medicines in line with their prescriptions. Staff undertook appropriate checks to determine their suitability for the post and before they started working with people. The service provided staff with protective clothing to minimise the risk of infection. The management team

had monitored the incidents and accidents occurring and took actions to reduce a likelihood of such events taking place in the future.

People had support to meet their dietary needs and requirements. Staff supported people to access health care professionals if they needed assistance which ensured their wellbeing was monitored and maintained. Staff had skills to use manual handling equipment and supported people to move safely. People received effective care based on their wishes.

People's views were listened to and staff provided support that was respectful towards the people's care needs and privacy. People were treated with dignity and kindness. Staff encouraged people to be as independent as possible and helped people to make choices about their daily activities.

People and their relatives were supported to raise concerns and complaints should they have any. People felt confident to approach the management team for making changes to their care and support if necessary.

There were quality assurance processes in place to monitor improvements required, however these were not always effective for reviewing and updating people care records. The registered manager had not notified the CQC about some incidents, but took all the necessary actions to improve safe care for people. Feedback surveys were completed regularly which ensured that people's views about the service were collected. Staff's understanding and confidence in following the service's policies and procedures was checked to ensure they were carrying out their duties as necessary. Staff felt supported by the management team when they approached them for guidance and assistance. Information was shared with healthcare professionals to support people's best interests and ensure good care.

The five questions we ask about services and what we found