Westminster Homecare Limited (Independent Living Network) was rated Requires Improvement overall at its October 2023 inspection, down from Good in 2017, due to incomplete risk assessments, inaccurate medicines administration records, and failure to report safeguarding incidents to the local authority. Strengths included compassionate, person-centred care, effective staff training, good MCA compliance, and strong multi-agency relationships.
Concerns (6)
criticalSafeguarding: “Incidents reported to the provider were not always sent to the local safeguarding teams for investigation.”
criticalGovernance: “Not all quality audit and monitoring processes were effective in identifying, and enabling improvements. For example, not reporting incidents to the local authority where people had experienced harm.”
moderateRecord keeping: “A person's risk assessment was not in their care plan we looked at. The registered manager told us this risk assessment had been misfiled whilst transferring records to an electronic system.”
moderateMedication management: “Not all people's medicines administration records (MARs) were complete or accurate. Where people were supported with medicines that had to be administered before food, the time they had been administered had not been recorded.”
moderateIncident learning: “Staff provided us with the investigation record for an incident involving harm, but they were not able to find the records for what learning had been undertaken.”
moderateCare planning: “Some risks to people had not been documented... information was not up to date on how to support people with drinking safely, such as the temperature of drinks and the drinking vessels to be used.”
Strengths
· Staff were trained and knowledgeable about safeguarding procedures and knew how to identify and report abuse.
· People were supported to have maximum choice and control of their lives in the least restrictive way possible.
· Staff received effective specialist training including autism, epilepsy care, diabetes, and communication approaches.
· Strong continuity of care with long-serving staff who knew people very well, providing person-centred support.
· Good infection prevention and control practices with correct and effective use of PPE.
Quality-Statement breakdown (21)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the law; Supporting people to eat and drink enoughGood
effective: Staff support: induction, training, skills and experienceGood
effective: Staff working with other agencies; Supporting people to live healthier lives and access healthcareGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported, respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; Continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empowering; Duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Working in partnership with othersRequires improvement