1 June 2019
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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was carried out by two inspectors.
Service and service type:
LLOYDS CARE GROUP LTD. is a domiciliary care service providing support and personal care to people in their own homes.
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.
Notice of inspection:
We gave the service two working days' notice of the inspection site visit, to provide the opportunity for the provider to contact people who use the service to gain their consent for us to contact them by telephone. This was to enable us to seek their views about the service they receive.
The Inspection site visit activity took place on 8 May 2019. We visited the office location to see the registered manager and office staff; and to review records.
What we did:
Before the inspection, we did not ask the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. However, the provider was given the opportunity to tell us all about the service and we took this into account when we made judgements in this report.
Our planning took into account information we held about the service. This included information about incidents the provider must notify us about, such as abuse; and we looked at issues raised in complaints and how the service responded to them.
We spoke with two people who used the service and four family members by telephone on 8 May 2019.
We spoke with four staff who were employed to provide personal care and support to people by telephone on 8 May 2019.
We spoke with the registered manager and the co-ordinator when we undertook the site visit.
We looked at the care plans and records of three people. We looked at two staff records, which included their recruitment, induction, on-going monitoring and training. We looked at the minutes of staff meetings and records related to the quality monitoring of the service, which included complaint investigations carried out by the registered manager.
1 June 2019
About the service:
LLOYDS CARE GROUP LTD. is a domiciliary care agency. It provides personal care to people living in their own houses or flats. At the time of the inspection there were 18 people using the service.
People’s experience of using this service:
At the last inspection on 5 September 2018 we asked the provider to take action to make improvements in a number of areas. These included; the assessment of people’s capacity to make informed decisions, the assessment and mitigation of risk, the recruitment, training and ongoing support of staff and effective oversight and governance of the service. We found some improvements had been made, however further improvements needed to be made.
People told us they felt safe, however improvements were needed. People in some instances had experienced missed or late calls. The registered manager had spoken with staff about the importance of timeliness and good communication. The registered manager was in the process of recruiting additional staff. We found improvements were needed to recruitment practices to ensure references were sought from the most appropriate person. People were kept safe by staff who understood how to safeguard people from abuse and the actions they needed to take to protect people from the risk of harm. There were appropriate infection control practices in place. People were supported to take their medicines safely.
Staff were provided with induction, however improvements to ensure staff had sufficient time to understand the information was needed. Training was provided; however, a majority of training was through e-learning, which the registered manager had identified was not staff’s preferred method of gaining knowledge. People were supported to have sufficient amounts to eat and drink. Staff supported people to maintain their health and well-being. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
People were consistent in their praise of staff for the support they provided. People spoke of the kind and caring approach of staff. Some people told us staff had time to talk with them. People’s privacy and dignity was promoted.
People were involved in the assessment and care planning process to ensure the services offered were appropriate for them. People were supported to express their wishes and preferences regarding their care and staff were provided with information, within people’s care plans, which enabled them to provide personalised care. People were confident to raise concerns and complaints, to which people received a verbal response.
The provider did not have a system in place to monitor the quality of the service to ensure people received good quality care. The registered manager had plans to expand the service and improve staff training. However, there were no plans produced by the registered person which identified how this would be achieved, the resources available or how any improvements would be monitored. Opportunities for people to comment upon the quality of the service were limited. People's views were sought by telephone, however there was no evidence to support how comments were collated or used to drive improvement. People and staff were positive about the approachability and support provided by the registered manager.
Rating at last inspection:
Requires improvement. The last report for LLOYDS CARE GROUP LTD., was published on 1 November 2018.
Why we inspected:
This was a planned comprehensive inspection based on the rating from the previous inspection.
We will meet with the Provider. We will return to re-inspect in line with our inspection timescales for Requires Improvement services.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk