The Care Quality Commission
  • Services in your home
  • Homecare service

Archived: Loga Care Limited

Overall: Requires improvement read more about inspection ratings

Unit 5, Abbey Business Park, Monks Walk, Farnham, Surrey, GU9 8HT (01252) 852100

Provided and run by:
Loga Care Limited

All Inspections

24 November 2016

During a routine inspection

This inspection took place on 24th and 25th November 2016.

Loga Care Limited provides 24 hour live-in care for adults of all ages with a range of health care needs. Care staff live in people’s home to provide their care. People may be living with dementia or have a physical or learning disability. There were 104 people using the service at the time of the inspection.

There was 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 rights were not protected because the staff did not act in accordance with the Mental Capacity Act 2005 (MCA). Staff were not knowledgeable about how to support people to make decisions. Decisions were being made by people who did not have the authority to make those decisions, and where people had restrictions placed on them there was no evidence that this was done in their best interests

There were times where people were not being protected against risks and action had not been taken to prevent the potential of harm.

Staff did not always have the up to date training they needed to remain up to date with good practices. It is the provider’s policy to only provide update training in safeguarding, moving and handling and medicines administration on an on-going basis.

The provider did not always have effective systems in place to monitor the quality of care and support that people received. In the last year they had completed one audit in July 2016. The audit did not identify that people were not being protected against risks, or that people did not have decision specific mental capacity assessments in place.

People were protected against the risks of potential abuse as staff had the knowledge and confidence to identify safeguarding concerns.

The service followed safe recruitment practices.

Accidents and incidents were documented and measures were introduced to support people to remain as safe as possible.

People were supported by staff who had supervisions (one to one meetings) with their line manager, but this was not effectively recorded. Staff were supported on a regular basis by Field Supervisors.

Care plans contained details on people’s food preferences and people’s dietary requirements. Examples of meals that were nutritious, balanced and liked by people were in care records.

People’s care records showed people’s health care needs were met effectively and their GP was involved in their care.

People told us that staff were caring and they were happy with the care they received

People received care and support from staff that had got to know them well. Care records contained information about people’s personalities and life stories to help staff get to know them.

People and their relatives were given a choice of staff. People could read about staff member’s backgrounds and were encouraged to speak to staff members on the phone to help them to make a decision about who they wanted supporting them.

The relationships between staff and people receiving support demonstrated dignity and respect at all times.

Care, treatment and support plans were personalised and detailed. Records contained information on people’s health needs and practical tasks that they required support with and person centred information about people such as their wishes, preferences and backgrounds. Guidance for staff was very specific to people’s individual needs.

Assessments covered people’s needs and captured important person centred information.

People were able to choose what activities they took part in and suggest other activities they would like to do.

People’s concerns and complaints were encouraged, investigated and responded to and were used as an opportunity for learning or improvement. Six complains had been made in the last year. They had all been responded to and had learning points identified.

The service communicated well with people and their relatives.

The office and manager communicated with staff well. The provider emailed a weekly newsletter to staff and staff were able to phone for advice and support at any time.

The registered manager valued people’s and staffs feedback and acted on their suggestions. Surveys were carried out in February 2016. In response the provider had put action plans in place.

We found several breaches of regulations. You can see what action was taken at the end of the report.

2 February 2015

During an inspection looking at part of the service

This inspection took place on 2 and 5 February 2015 and was announced. Loga Care Limited provides 24 hour live-in care for adults of all ages with a range of health care needs. Care staff live in people’s home to provide their care. People may experience dementia or have a physical or learning disability. Loga Care Limited also provides a live-in palliative care service. There were 99 people using the service at the time of the inspection. The service was last inspected on 22 April 2013 and no breaches of the regulations were identified.

The service has a registered manager. 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.

Everyone we spoke with said they felt safe. One said “Safe, absolutely” and another said they were “100% safe.” Staff had completed safeguarding training and had access to guidance. They were able to recognise if people were at risk and knew what action they should take. The registered manager had taken action when people had been identified as at risk and learning had taken place. People were kept safe as safeguarding incidents were reported and acted upon.

People had comprehensive risk assessments. Where risks had been identified there were plans to manage them effectively. Staff understood risks to people and followed guidance. Staff were alert to changes in people’s usual presentation. They recorded incidents and reported them to the office staff, who then took appropriate action such as liaising with health professionals.

There were sufficient staff to provide people’s care. Additional staff could be provided at short notice. People were safe as staff underwent comprehensive pre-employment checks.

One person told us they took their own medicine and the care staff supported them with re-ordering medicine. Staff undertook medicines training and had a medicines competency check. Staff had been required to update their medicines training if they made an error but the provider informed us they would now require all staff to update this training annually. Staff followed guidance and sought advice as required. People’s medicines were managed safely.

The provider had increased the length of the staff induction programme. Staff completed further training relevant to people’s needs and were supported to undertake professional qualifications. Systems were in place to support staff and monitor their work. People’s care was provided by staff who were sufficiently trained and supported.

Staff completed training on the Mental Capacity Act (MCA) 2005 and understood their role. Where people lacked the capacity to consent to their care relevant guidance had been followed. The provider was aware of anyone who was legally appointed to make decisions for people. They contacted advocacy services for people where required. The provider had not documented in their assessment why they believed people lacked capacity in accordance with good practice. They have informed us they have taken action to address this. The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to community services. The provider is required to submit an application to the Court of Protection if they assess a person’s liberty is restricted. The registered manager had completed relevant training and was aware of case law.

People’s needs in relation to nutrition and hydration were documented. People received appropriate support to ensure they received sufficient to eat. Meals reflected people’s dietary needs and preferences.

Everyone we spoke with said care staff were caring. One said, “She really cares” another commented “The one I’ve got at the moment is excellent.” People told us staff treated them with dignity and respect. Staff were observed to treat people with dignity and respect. The ability and suitability of staff to form caring relationships with people was assessed as part of their recruitment process. People were matched with suitable staff and received information about staff on which to base their choice.

Staff worked with health care agencies to provide people with palliative care at home in accordance with their wishes. Staff who worked with people receiving palliative care were experienced and had training. The provider was arranging additional staff training to further improve end of life care planning.

People felt involved in their care planning and making decisions about their care. People’s needs were assessed prior to the commencement of the service. As staff familiarised themselves with people’s preferences and their needs, their care plans were amended. Care plans were personalised. People were supported to maintain their independence.

People experienced smooth transitions in their care between staff. Care staff had adequate time to complete handovers of the person’s care and these were documented. This provided the incoming care staff with up to date information about people’s needs.

The registered manager ensured people had information and support to make complaints. Where complaints were made they were investigated and actions taken in response. Complaints were analysed for themes and where these had been identified action had been taken.

Staff had received training in the ethos and values of the provider as part of their induction. Staff were seen to uphold the provider’s values in the course of their work with people.

The majority of people told us there were good communications from the office and they knew who to speak with. Staff were encouraged to speak with the office about any concerns they had about people’s care. They felt able to do this openly and without fear of retribution. The registered manager had noted a culture of under reporting of incidents amongst staff when they started. They had taken effective action to ensure staff knew what they should report and how.

There had been a change in the ownership of the company providing the service and management in the past six months. Staff felt supported by the new leadership. The new management understood the challenges facing the service in relation to managed growth and staffing. They were taking measures such as increasing office staffing and improving the IT systems to support growth. There were systems in place for the provider to receive reports on the quality of the service provided. People’s care was provided by management that was managing the growth of the business and monitoring quality.

Most people said someone from the agency called two or three times a year to monitor the quality of care provided and to check staff performance. People’s feedback on the service was sought through telephone calls when there had been a change in staff. People’s views had been sought through the annual quality survey. The provider intended to develop an action plan from the next survey, to learn from people’s experiences.

The registered manager worked with other services to ensure they received relevant information about people’s care. Staff contacted other agencies for support with people’s care as required. The provision of people’s care was co-ordinated with other services.

22 April 2013

During a routine inspection

We spoke with four people in total. This included people who used the service, people's relatives and their representatives. They told us 'The carer's I have are fantastic' and 'We are always happy with the quality of the service'.

We found people were provided with information about both the service and their own care.

People had been involved in planning their care and were able to express their preferences with regard to their care. People's dignity and privacy had been maintained whilst their care was provided.

We found people had been supported to promote their independence and community involvement.

People's needs had been assessed prior to them being offered a service. People had care plans that identified their needs and provided staff with guidance with regard to how people's needs were to be met. The provider had taken measures to try to ensure care staff were appropriately matched with people.

The provider had ensured that staff had received training in how to safeguard people who were at risk from abuse. Staff were aware of their responsibilities and the guidance available to them.

The provider had ensured they had recruitment processes in place and that appropriate checks were undertaken before staff commenced their role.

People's feedback about the service was sought regularly and in a variety of ways. The quality of the service provided was also monitored through audits.