Archived: LIVE IN CARE4U LTD

Updated 1 May 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was undertaken by one Inspector.

Service and service type

Live in Care 4U Ltd is a care at home service and provides live-in care to people in their own homes. The service had a manager registered with the Care Quality Commission. They were also the provider. This means they are legally responsible for how the service is run and the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was to ensure that the registered manager was in the office to support the inspection and so that people and their relatives were informed of our inspection and would be at home to receive our calls.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We had not asked the provider to submit a provider information return (PIR) since the last inspection. A PIR is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. A discussion took place with the registered manager to enable them to share this information with us. We took this into account when making our judgements in this report.

During the inspection

We were advised by the registered manager and people's relatives that people would be unable to speak to us. We spoke with two relatives, two members of staff and the registered manager. We reviewed a range of records about people’s care and how the service was managed. These included the individual care and medicine administration records for three people. We looked at four staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, which included policies and procedures, were also reviewed.

After the inspection

We sought assurances from the registered manager in relation to the care people received and staffs’ skills. We made a safeguarding adults’ at risk referral to the local authority for them to consider as part of their safeguarding responsibilities.

Updated 1 May 2020

About the service

Live in Care 4 U Ltd is a care at home service that provides live-in care staff for people living in their own homes. The provider is based in Rudgwick, West Sussex and people receiving care at home services were based in other areas of the country. At the time of the inspection there were two older people using the service, one of whom was living with dementia and another who experienced difficulties with their cognition.

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

There were wide spread and significant concerns about the lack of oversight and regard for people’s care. Risks to people’s safety had not been identified, assessed or managed effectively and lessons had not always been learned. This included, falls management, hydration and nutrition, medicines management, safeguarding adults at risk and environmental risks. People were not always protected from the risk of abuse and improper treatment. Following the inspection, we made a safeguarding referral to the local authority about one person’s care.

There was insufficient oversight and systems and processes were not operated effectively to provide assurances of staff’s practice or the care people were receiving. Quality assurance processes were not used to monitor people’s day-to-day care to ensure they were receiving safe care and treatment. The registered manager had failed to continually improve the service. People and relatives had not been asked for their feedback about the service they received. Policies and procedures were not implemented in practice.

Staff had not been supported to undertake robust and thorough inductions and had not received training before providing live-in care and support to vulnerable people who lived alone. Staff’s competence had not been assessed and the registered manager had not always observed staff supporting people to assure themselves staff had appropriate skills and abilities. People’s needs had not always been identified or assessed. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

One person did not always receive dignified care that respected their rights. Staff were provided with insufficient guidance to inform their practice and ensure people received support that met their needs. People had not been supported to plan for care at the end of their lives.

We recommended the registered manager sought advice and guidance from a reputable source to ensure there were effective systems to assess, plan and meet people’s needs.

There were enough staff to meet people’s needs. Relatives told us they had confidence in staff’s skills. Staff worked in partnership with external healthcare professionals to support people to maintain their health or seek assistance if they were unwell. Infection prevention and control was maintained.

Relatives praised staff’s caring approach and attentiveness. People were supported with their social needs and had access to the local community as well as pass times they enjoyed.

Rating at last inspection

The last rating for this home was Good (Published 9 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified seven breaches in relation to oversight of risks and safety, risk of abuse and avoidable harm, dignity and respect, consent, staff skills and competence, failure to notify CQC of incidents and the leadership and management of the service. Please see the action we have told the provider to take at the end of this report.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within six months to check for significant improvements.

If the provider has not made enough improvement within this timeframe, and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Follow-up

We will continue to monitor the intelligence we receive about this service. We will request an action plan from the provider to understand what they will do to improve the standards of safety and governance. We plan to inspect in line with our re-inspection programme. If we receive any concerning information we may inspect sooner.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Live In Care 4U Ltd on our website at www.cqc.org.uk.