Background to this inspection
Updated
9 April 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. This inspection was planned to check 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Inspection team
This inspection was conducted by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults.
Notice of inspection
We gave the service 24 hours’ notice of the inspection visit because we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 03 March 2020 and ended on 12 March 2020. We visited the office location on 03 March 2020.
What we did before the inspection
We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
During the inspection, we spoke with the registered manager who is the owner and one care staff. We looked at five people’s care records. We looked at three staff files in relation to recruitment and staff supervision records. Multiple records relating to the management of the service and a variety of policies and procedures developed and implemented by the provider were reviewed during and after the inspection.
After the inspection
We continued to seek clarification from the provider to corroborate evidence found. We looked at training data and quality assurance records and staff rotas. We spoke to professionals from the local authority, one person who used the service and five relatives via telephone to seek their views about the care. We also spoke to two care staff.
Updated
9 April 2020
About the service
Leah Victoria Cares provides personal care to people living in their own houses and flats in the community. Not everyone who used the service received personal care. Care Quality Commission (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. At the time of our inspection the service was providing personal care to 19 people.
People’s experience of using this service and what we found
People told us they received safe care and treatment and spoke positively about the care staff and the support the service provided. However, the providers’ risk management practices were not robust, this included the lack of ongoing training in areas such as infection prevention. The registered manager needed to improve their recruitment practices to protect people from unsuitable staff. We made a recommendation about this.
People’s care records provide adequate detail regarding their care needs and how risks around them would be monitored. People and family members knew how to make a complaint and they were confident about complaining should they need to. They were confident that their complaint would be listened to and acted upon quickly.
The registered provider’s governance systems did not always support the delivery of safe care and compliance with regulations. Systems for maintaining care records, risk management, auditing staff training and supervision were not always in line with current practice. People and staff shared positive feedback regarding the support they received from the registered manager.
Medicines management practices were not robust, we made a recommendation about this. Some of the staff had received safeguarding training and staff knew how to report concerns about abuse.
The registered manager had supported staff with a range of training, however improvements were required as majority of the training had not been updated in line with the providers’ policy. Staff supported people to have maximum choice and control of their lives. However, improvements were required to ensure people’s ability to consent to care and make their own decisions was assessed. We made a recommendation about seeking consent.
People received support to maintain good nutrition and hydration and their healthcare needs were understood and met.
People and their relatives told us they were treated with dignity and staff were respectful of their homes. Staff knew how to maintain people’s privacy and confidentiality. They were respectful of people’s protected characteristics such as gender, cultural and religious needs. One relative told us, “The care is excellent, they try to get [relative] independent and on an emotional level they are very kind.”
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
At the last inspection the service was rated good. (published 05 September 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement:
We have identified breaches in relation to risk management, good governance, record keeping at this inspection. You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.