LSC Nursing & Domiciliary Care Services Limited

LSC Nursing & Domiciliary Care Services Limited is a domiciliary care service providing personal and nursing care to paediatrics, children and adults, some of whom have complex nursing needs. At the time of our inspection 27 people were receiving care.

Not everyone who uses the service may receive 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.

People’s experience of using this service and what we found

People were cared for safely and staff understood their responsibilities to keep people safe from avoidable harm or abuse. Risks to people's safety were managed and appropriate action was taken to keep people safe. Staff managed people’s medicines safely and made sure they received them when they needed them. People were supported by staff who had been recruited safely. Staff practice helped to reduce the risk of cross infection.

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’s nursing and care needs were met by effective assessment and planning. Staff took account of people’s holistic needs when planning care. The provider worked with other healthcare professionals to help ensure people's care and health needs were effectively met. Staff had received training to enable them to provide safe and effective care to people.

People were cared for by staff who were kind and compassionate. People were involved in decisions about their care and support needs. Staff respected people’s privacy and dignity.

People’s care and support was personalised to their needs. People were supported in a way which made sure they were treated fairly and not discriminated against. People's individual needs and wishes were known to staff who had developed positive relationships with them. There were arrangements in place for people to raise concerns about the service.

People had confidence in the management of the service and felt they received good quality care. The provider used a variety of methods to check the quality of the service and developed good practice within the staff team. Staff were supported in their roles and shared the provider’s values of delivering the best care they could.

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 this service was good (published 24 December 2016).

There was 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.

People were supported by staff who knew how to keep them safe. People’s risks had been assessed and minimised through the use of risk assessment and staff had a good knowledge of people and their risks.

People received their medicines safely by competent staff. There were systems in place to check people received their medicines safely. There were sufficient numbers of suitably trained staff to keep people safe, who had been employed using safe recruitment procedures.

People’s human rights were protected as they consented to their care and support, or were supported to do so by their representatives. People were supported by staff who understood the principles and application of the Mental Capacity Act.

People received care that met their individual needs and preferences. People told us that staff were kind and caring and that staff supported people in a way that maintained their privacy and dignity and promoted their independence.

Staff were supported to fulfil their role effectively. There was a regular programme of training that was relevant to the needs of people, which was kept up to date.

When people became unwell, staff responded and sought the appropriate support, and the provider worked with other health professionals when required to meet people's needs. People received sufficient to eat and drink to maintain a healthy diet.

People and staff were encouraged to give feedback on the service and the provider had a complaints procedure and people knew how to use it.

Staff felt supported by the management team and felt confident their concerns would be taken seriously, and the provider had systems in place to monitor the quality of the service to identify ways to mitigate further risks for people who used the service.

We used the telephone to speak with people about the service. We spoke with two clients, four family members of clients, two commissioners and eight members of staff.

We received almost all positive feedback from people we spoke with. We were told about issues that had been raised by one client that had since been resolved. People told us they found it reassuring to be able to discuss any problems or queries with any of the management team.

We looked at how staff gained consent from people and how their care and welfare needs were met. Staff told us how they used the care plan, risk assessments and good communication to ensure people's preferences and needs were met.

We looked at the use of equipment in people's homes and how staff ensured people's safety. One person told us: "The staff are very safety conscious. They protect my privacy when they move me and they always tell me what is going to happen next".

We reviewed the agency's recruitment of staff. One member of staff told us: "I have been well trained and supported since I joined the team. I only have to ask if I'm not sure. I enjoy my work". We looked at the complaints log and the agency's procedure.

We saw that people's care plans were personalised and the person's individual choices and preferences were the foundations of the plan. People told us they were asked to sign their care records after the care records was discussed, which evidenced that the agency involved people in planning their care.

We saw evidence that the administration of medication by the agency staff adhered to the policies and procedures. We saw that staff training and competence checks were completed prior to administering medicine in the community.

The agency's care co-ordinator managed the staff rota's to ensure that sufficient staff were available to meet the people's needs at their preferred time by a regular carer that they were familiar with.

The agency regularly audited their processes and procedures to ensure that a high quality service was being delivered and maintained.