Background to this inspection
Updated
1 December 2023
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 carried out by 1 inspector, a medicines inspector and an 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 homes.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection.
Inspection activity started on 25 September 2023 and ended on 6 October 2023. We visited the location’s office on 25 September 2023.
What we did before the inspection
We reviewed the Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We also reviewed the information we already held about the service. This included their previous inspection reports and notifications. A notification is information about important events, which the provider is required to tell us about by law. We used all of this information to plan our inspection.
During the inspection.
During our site visit, we spoke with the nominated individual, registered manager and the quality assurance officer. The nominated individual is responsible for supervising the management of the service.
We reviewed documents and records related to people’s care and the management of the service, which included 6 people’s care plans and medicine records.
We reviewed 5 staff files, which included pre-employment checks. We looked at other documents such as quality assurance and training records.
We spoke to 4 people who used the service and 6 relatives of people who used the service on the telephone to receive their feedback about the service. We also spoke to 5 staff members on the telephone to check if they knew about the people they supported.
Updated
1 December 2023
About the service
Livingstone Healthcare Limited is a domiciliary care agency and is based in the London Borough of Barking & Dagenham. The service provides personal care to people in their own homes. 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.
The service was supporting 13 people with personal care at the time of the inspection.
People’s experience of using this service
Risks assessments were not always robust to ensure people received safe care. Medicines were not always being managed safely. Robust systems were not in place to ensure staff attended calls on time. Pre-assessments systems were not robust in capturing people’s preferences and risks. Care plans did not always include people’s preferences with personal care to ensure they received person centred care. We made a recommendation in this area.
Robust audit arrangements were not in place to ensure shortfalls could be identified and prompt action taken.
Incidents were recorded to ensure lessons were learnt. People were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff were aware of how to safeguard people from abuse. Systems were in place to prevent and minimise the spread of infections when supporting people. Pre-employment checks had been carried out to ensure staff were suitable to work with people. Systems were in place to ensure feedback was received from people on their care.
Staff had been trained to perform their roles effectively. Staff supervisions were regular to ensure staff were being supported at all times.
People received care from staff who were caring and had a good relationship with them. Staff respected people’s privacy and dignity. People were encouraged to be independent and to carry out tasks without support.
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 the service was Good, published on 13 July 2021.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
The overall rating for the service is now Requires Improvement. This is based on the findings at this inspection.
You can read the report from our last inspection, by selecting the ‘all reports’ link for Livingstone Healthcare Limited on our website at www.cqc.org.uk.
Enforcement and recommendations
We have identified breaches in relation to need for safe care and treatment, staff timekeeping and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
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.