Background to this inspection
Updated
30 July 2019
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
This inspection was carried out by a single inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
We gave a short period notice of the inspection because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used the information from these sources to plan our inspection
During the inspection
We visited the office on 11 June 2019. We spoke with the registered manager, a care manager and an office administrator. Following the office visit we spoke with one person using the service, a relative and one care worker by phone. We reviewed two people's care and support plans and four staff recruitment and training records. We also reviewed records used to manage the service, for example, complaints, meeting minutes and audits. We contacted the local authority to ascertain their views about the service.
After the inspection
We asked for some information to be sent to us, this included meeting minutes and continued to seek clarification in relation to some of the evidence gathered.
Updated
30 July 2019
About the service
LifeCome Care Bromley is a domiciliary care service providing personal care to adults living in the community. 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 this inspection the registered manager told us there were two people using the service who received personal care.
People’s experience of using this service and what we found
Some risks to people were identified and assessed and suitable guidance given to staff. However, we found a new breach of regulation as a health risk was not fully assessed or sufficient guidance given to staff to manage this risk safely. There were systems to track and monitor the quality of the service. However, these were not yet sufficiently effective and required improvement to ensure they covered all aspects of the service and that they were effectively operated.
Action had been taken to address the breaches and areas for improvement found at the last inspection in March 2018. Complaints were recorded and investigated appropriately. People and their relatives spoke positively about the care and support they received, and the way staff interacted with them. We saw that people’s preferences in relation to having male or female staff were recorded and respected.
There were enough staff to meet people’s needs and people told us staff were reliable. Some aspects of medicines management were managed safely.
Staff received enough training and support to meet people’s needs. People were supported to have enough to eat and drink where this was part of their support plan. 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.
People were supported to be as independent as possible and told us staff treated them with dignity and respect. People had a personalised plan for their care which identified and assessed any support needed in relation to their protected characteristics.
People and their relatives told us they thought the service was organised and their views were sought and listened to. Staff told us the registered manager was supportive and approachable.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was ’Requires Improvement’ (published 15 June 2018) and there were two breaches of the regulations, relating to complaints and good governance .
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection enough improvement had been made in relation to the regulations identified at the last inspection, but the provider was in breach of another regulation and there remained some improvements needed. The service therefore remains rated 'Requires improvement' for the second time.
Why we inspected
This was a planned inspection based on the previous rating.
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.