Lily Mae Homecare Limited

Lily Mae Homecare Limited is registered as a domiciliary care agency providing the regulated activity ‘personal care’ to people who live in their own homes in Market Deeping, Bourne and Stamford. At the time of the inspection visit there were 44 people using the service.

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

Systems were in place to ensure the safety of people being cared for. Records showed, and staff confirmed they had received safeguarding training and were knowledgeable about how to recognise and protect people from abuse. Risks to people were assessed and managed. Medicines were managed, procedures were in place to support this. Safeguarding issues and complaints were analysed, and improvements were made. Lower level accidents and incidents were recorded and reviewed to help learn when things go wrong.

Records confirmed staff were recruited safely.

People’s needs were appropriately assessed, and outcomes were met. Records showed, and staff confirmed that they received the training they needed to do their job well. Specialised training to support people who required more complex support was provided.

People's nutritional needs were met, those with more complex needs who required a specialised diet were catered for. Care records were detailed, and staff described the support required to assist people with swallowing needs well. 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 consent to care was not recorded in their care records. We acknowledged verbal agreements were reached when people start using the service, but this was not recorded to demonstrate people are receiving the care which has been agreed and they consent to it.

The provider immediately implemented a simple process to address this.

The service being delivered was caring and was delivered by a staff team who were kind, considerate and empathetic. Staff described a 'family' atmosphere and approach. The registered provider had the interests of people using the service and their staff team at heart. People were given the opportunity to express their views. Staff demonstrated good awareness of how to maintain privacy and dignity.

People were receiving care which was responsive to their needs. People were consulted about the care they received and were asked for feedback. People would benefit from learning more about what action is being taken to address their concerns. The registered manager was aware of this and was considering how to feedback from the latest quality assurance surveys. Complaints were well managed we saw evidence of good customer satisfaction and compliments.

The provider has a clear direction and vision. Leadership is visible, accessible and the management team lead by example. Staff were complimentary of the support they receive from the management team. Morale in the team was good and there was a good team working ethos.

Processes were in place to ensure that the delivery of care was monitored and checked regularly. Plans for improvement were implemented and actioned. The registered manager and the team work in partnership with other health and social care professionals within the community.

Rating at last inspection

At the last inspection the service was rated Requires Improvement and was published on 21 December 2017.

Why we inspected

This was a scheduled inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults of all ages, some of who may be living with a physical disability or dementia.

Not everyone using Lily Mae receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager in place. 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.

This was the services first inspection since their registration with the Care Quality Commission.

The provider was not meeting the legal requirements in relation to managing people’s medicines safely and completing the appropriate checks to ensure that staff were safe to work with people using the service before they started work. You can see the actions we have asked the provider to take at the back of this report.

The provider’s policies and procedures reflect the latest best practice guidelines and latest legislation. However, the provider did not ensure they embedded the policies in managing the service. Audits to monitor the quality of care people received had been completed but they had not always been effective in improving the quality of care people received. People’s views on the care they received were gathered and reviewed to ensure any concerns were identified.

Most risks to people were identified and care planned to keep people safe. However, the people’s ability maintain healthy skin was not assessed and therefore proactive care was not in place. Risks around the environment were identified and any changed needed discussed with people. Infection control processes kept people safe from the risk of cross infection.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

There were enough staff available to meet people’s care needs in a timely manner and people benefitted from having visits from a consistent group of staff who got to know them and their care needs. People told us that the staff were kind, caring and responsive to their needs. Staff received the training needed to enable them to provide safe care. They also benefitted from regular supervision meeting with the registered manager to discuss any concerns or training needs.

People had been involved in planning their care and care plans contained the relevant information needed so that staff could tailor the care to people’s individual needs. Staff worked collaboratively with other agencies to ensure any healthcare concerns were address. People’s needs at the end of their lives were identified and compassionate care was put in place.