Liral Veget Training and Recruitment Ltd

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm

The last rating for this key question was requires improvement. At this assessment the rating has remained requires improvement.

Requires improvement: This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

At this assessment we identified 3 breaches of regulations. The provider failed to signpost the contact details of commissioners and safeguarding teams of relevant local authorities in people’s easy read complaint policy and service user guides. People were not always protected from avoidable harm. The provider was not working within the principles of the MCA.

Despite the above, relatives gave us positive feedback about feeling safe when receiving care and the provider engaged well with them, care workers are trained and knowledgeable to meet people’s needs.

This service scored 53 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There were systems and processes in place to manage accidents and incidents when care workers were delivering personal care.

Care workers told us that there were occasional team meetings, and they had regular supervision with their line manager in which accidents and incidents were discussed to ensure learning was shared. One care worker said, “I have supervision every 3 months, we always talk about any incidents and what needs to change.”

The registered manager developed integrated care plans that clearly delineated which agency was responsible for the different aspects of support to people, and they kept separate records of care provided.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

At our last inspection the provider had failed to operate systems to safeguard people from abuse. This was a breach of Regulation 13. At this assessment, we found the provider had made the required improvement and there was no longer a breach of Regulation 13. However, they were in breach of Regulation 17.
The provider failed to signpost the contact details of commissioners and safeguarding teams of relevant local authorities in people’s easy read complaint policy and service user guides. This meant people and their relatives did not have easy access to information that they needed to raise concerns or make a complaint.

Despite the above, relatives gave us positive feedback about feeling safe when receiving care from care workers. A relative told us, “Yes, very safe and I am very happy.” Another relative said, “Yes, my loved one is safe. Sometimes I go unannounced, and my loved one is always happy and safe.”

People were protected from the risk of abuse. The provider had a policy and procedure for safeguarding adults from abuse. The registered manager and care workers understood the different types of abuse, and the signs to look for. Care workers were aware of the action to take if they suspected someone had been abused including reporting their concerns to the registered manager.

The registered manager told us there had been no safeguarding incidents since the previous inspection. There were systems and processes in place to manage and follow up on accidents and incidents. Care workers completed safeguarding training. However they were not aware about the procedure for whistle-blowing and whom to report and escalate concerns, except for contacting their manager.

At our last inspection the provider had failed to ensure appropriate capacity assessments had been conducted and applications to the necessary court of protection made. We made a recommendation about this. At this assessment we found the provider was in breach of Regulation 11.

The provider had failed to work within the principles of The Mental Capacity Act 2005 (MCA) to ensure consent to care and treatment was obtained, in line with law and guidance.

The registered manager had assessed the capacity of each person to consent to their care and support. We saw that where people had been assessed as not having capacity to understand and make this decision, decisions made in their best interests were not always documented in their care and support records.

At our last inspection the provider had failed to manage known risks to people safely. This was a breach of Regulation 12. At this assessment, we found the provider had made some improvements however they remained in breach of Regulation 12.

People were not always protected from avoidable harm. Risk assessments and risk management plans were completed for some people which included guidance for care workers. However one person was identified as at risk of self-harm and causing harm to others there was no risk mitigation plan to guide staff while providing personal care, about recognising triggers and approaches to de-escalating their anxiety. Another person had an identified risk with a health condition. There was no risk assessment and mitigation plan and guidance for staff about how to manage skin health or foot health.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

At our last inspection, there was a breach of Regulation 18. At this assessment, the provider had made the required improvement and there was no longer a breach of Regulation 18.

People were supported by effectively deployed care workers. One relative told us, “Yes, my loved one has enough staff [care workers], they are very nice and keep me updated and let me know if they need my support.” Another relative said, “Yes, honestly, they [care workers] receive training, and they tell us they get it. They know my loved one well.” A third relative commented, “Yes, they [care workers] are trained, because with the right training they can support my loved one well and they do. They understand my loved one’s needs well.”

The provider supported care workers through induction, supervision, and training to ensure they had the appropriate knowledge and skills to meet people’s needs.

Training records confirmed that care workers had completed training that was relevant to people’s needs. One care worker told us, “I have had training in autism, epilepsy, dysphagia, safeguarding adults and children, food and nutrition, duty of care – lots of training.”

Care workers told us they felt there were enough staff to meet people’s needs safely and appropriately and there was on-call management support available for care workers as and when required.

The provider carried out satisfactory background checks for all care workers before they started working. These included checks on care workers qualifications and relevant experience, their employment history and consideration of any gaps in employment, references, criminal record checks and proof of identification. This reduced the risk of unsuitable staff working with people who used the service. However, for 1 care worker a police check was not obtained prior to their employment which placed people at risk of harm. Following our feedback a risk assessment was put in place.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

At our last inspection the provider had failed to ensure the safe administration and management of medicine. This was a breach of Regulation 12.

At this assessment, the registered manager told us that Liral Veget Training and Recruitment staff no longer supported people with medicines apart from the administration of topical creams. People’s care and support records confirmed this.

We reviewed people’s body maps and medicines administration records for topical creams. These were applied as prescribed.