Background to this inspection
Updated
11 May 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 11 and 18 February 2015 and was announced. We gave the provider 48 hours' notice because the location provides domiciliary care for adults and the manager is often supporting staff; we needed to be sure that they would be in.
The inspection was conducted by one Inspector 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 supporting adults with a range of care needs.
Before the inspection we reviewed the information that we held about the service. This included statutory notifications and safeguarding alerts and three previous inspection reports. We also contacted the safeguarding teams at the local authorities who commission the service.
We spoke with 14 people who use the service, five relatives, 12 members of staff and the registered manager. We also reviewed 16 people's care files and 15 staff files, and a range of policies and procedures, training records, accident and incident logs and service user feedback surveys.
Updated
11 May 2015
The inspection took place on 11 and 18 February 2015. We gave the provider 48 hours' notice because the location provides domiciliary care and the manager is often supporting staff. We needed to be sure that they would be in. At the last inspection in October 2013 the provider was not compliant with Regulation 18 Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 about people's consent to care. The provider was compliant with this regulation at the follow-up inspection in April 2014.
Lifecare Professionals is a domiciliary care agency providing care for 180 people and had 123 staff at the time of this inspection. The service provided home care for adults with learning disabilities, mental health conditions, physical disabilities, older people and people with dementia.
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.
Safeguarding adults from abuse procedures were clear and staff knew the different types of abuse and how to report any concerns they had about people's safety. All staff had received safeguarding training and demonstrated a good understanding of their responsibilities in keeping people safe.
There were not always sufficient staff to meet people's needs. We saw that during busy periods some staff had worked long hours, seven days per week which put both them and people receiving care at risk of harm.
Staff were well trained and have received core training and had access to additional training to increase their skills. Staff were supported with regular supervision and annual appraisals to maintain the quality of their care.
People were asked for their consent for care to take place. We saw detailed records of people's consent to care, which were signed and dated by people who used the service.
Staff had good caring relationships with people they supported. Staff knew people well and had a good understanding of their needs, their backgrounds and made sure they respected people's religious and cultural beliefs.
People were actively involved in their care, and participated in reviews of their care plans and could discuss their care with the registered manager.
Care was responsive to people's needs but was not always properly recorded. Staff knew about people's preferences and how they wanted to receive care. However, care plans did not reflect this and did not contain people's preferences, life histories or needs and only listed care tasks to be performed.
Staff, people who used the service and relatives all felt able to speak with the registered manager and provided feedback about the service. People who used the service knew how to make a complaint and there was an effective complaints procedure in place.
At this inspection there were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to staffing and person-centred care. The provider recognised the hours worked by some staff were too high and has put a new process in place to cap the hours worked. You can see what action we told the provider to take at the back of the full version of this report.