Archived: Lincolns Care Ltd

Updated 9 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The announced inspection site visit activity started on 21 March 2018 and ended on 27 March 2018. We gave the provider 48 hours’ notice of the inspection. This was so that we could be sure that the registered manager and staff would be available during this inspection. The inspection was carried out by one inspector. We visited the office location on 21 and 27 March to see the registered manager and staff, to review care records and records in relation to the management of the service. We spoke with a person and relatives of people who used the service on the 22 and 27 March 2018.

The provider did not meet the minimum requirement of completing the Provider Information Return of at least once annually. 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 made judgements in this report.

Before the inspection we looked at all the information we held about the service and the provider. This included information from notifications received by us. A notification is information about important events which the provider is required to send to us by law. We also asked for information from representatives of both the local authority contracts monitoring team and quality improvement team, safeguarding team; and Health watch. We sent out questionnaires to people, relatives of people who used this service and health and social care professionals to feedback on the quality of care provided prior to the inspection,. This helped us with planning this inspection.

During the inspection we spoke with one person and three relatives of people who used the service. We also spoke with the nominated individual, the registered manager; a senior support worker and two support workers.

We looked at two people’s care records and records in relation to the management of the service; accident and incident records; business continuity plan; management of staff; and the management of people’s medicines. We also looked at the provider’s statement of purpose; policies and procedures on training, end of life care, medication and recruitment; service user guide; surveys; meeting minutes; compliments received; staff training records; and four staff files.

Updated 9 May 2018

Lincolns Care Ltd 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 and younger adults.

Not everyone using Lincolns Care Ltd receives the regulated activity; CQC 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.

This announced inspection took place on 21, 22 and 27 March 2018. This was the first inspection of this service since their CQC registration changed in December 2016. There were nine people, receiving the regulated activity of personal care at the time of this inspection.

The service had 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.

Staff had an understanding of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Although not all peoples capacity had been formally assessed. Staff knew how to and where to report any suspicions poor care practice or harm.

People were assisted to take their medication as prescribed. However there were some inconsistencies within people’s care records and risk assessments over whether people were able to manage their medication themselves or required staff assistance.

Processes were in place and followed by staff members to make sure that infection prevention and control was promoted and the risk of cross contamination was reduced as far as possible when supporting people.

Staff assisted people in a caring, patient and respectful way. People’s dignity and privacy was promoted and maintained by the staff members supporting them.

People and their relatives were given the opportunity to be involved in the setting up and review of people’s individual support and care plans. People were supported by staff to have enough to eat and drink.

People were assisted to access a range of external health care professionals and were supported by staff to maintain their health and well-being. Staff and external health care professionals, would, when required, support people at the end of their life, to have a comfortable and as dignified a death as possible.

People had care and support plans in place which documented their needs. These plans informed staff on how a person would like their care and support to be given, and how it was to be given in line with external health and social care professional guidance. However, some people’s care, support plans lacked detailed information for staff on how to assist people with their specific health conditions and support needs.

There were enough staff to meet people’s individual care and support needs. Individual risks to people were identified and monitored by staff. Plans were put into place to encourage people to live as safe and independent a life as practicable. However, people’s risk assessments sometimes lacked detailed information as guidance for staff to refer to on how to mitigate people’s known risks.

Accident and incidents that occurred at the service were recorded. Learning from these incidents were communicated to staff during team meetings. This was to reduce the risk of recurrence and drive improvements forward.

There was a recruitment process in place and staff were only employed within the service after all essential checks had been suitably completed. The standard of staff members’ work performance was reviewed through spot checks, supervisions and appraisals.

Not all staff had been sufficiently trained to be able to provide care which met people’s individual needs effectively and safely.

Compliments about the care and support provided had been received. Records showed that there had been no documented complaints received by the service since the last inspection.

The registered manager sought feedback about the quality of the service provided from people, and their relatives. Audits were undertaken to monitor the quality of the service provided. However, shortfalls that had been identified, action to bring about the required improvement had not always been recorded to demonstrate that action had been taken.

The provider’s records showed that some incidents that the provider was legally obliged to notify the CQC of had been submitted.

Further information is in the detailed findings below.