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LLOYDS CARE GROUP LTD Requires improvement

Reports


Inspection carried out on 8 May 2019

During a routine inspection

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.

Follow up:

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

Inspection carried out on 5 September 2018

During a routine inspection

This inspection took place on 5 September 2018 and was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, and younger disabled adults.

At the time of our inspection visit eight people were using the service. Not everyone using LLOYDS CARE GROUP LTD receives a regulated activity; CQC only 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 consider any wider social care provided.

This was the first inspection of the service since they were registered on August 2017. At this inspection we found evidence to support the rating of ‘requires improvement’.

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.

The provider did not have systems and processes to assure themselves about the quality of service provided. There was a lack of oversight on the service and inconsistences in practices.

The provider did not system to log incidents and accidents, which meant they were unable to identify trends and take action.

Staff recruitment processes were not always followed to ensure suitable staff were employed.

Systems were not in place to ensure staff received the essential training needed for their role and were not supported or supervised. Lessons were not learnt or shared with the staff team.

People were at risk of receiving unsafe care. Risks associated with people’s needs and safety was not assessed, managed and reviewed. Care plans lacked guidance for staff to follow and information about people’s backgrounds, cultural needs and how they wished to be supported. further action was needed to monitor people’s care to ensure the care and support provided remained appropriate.

The registered manager did not understand and meet the Mental Capacity Act 2005 requirements. Therefore, people were at risk of not being supported to have maximum choice and control of their lives and were deprived of their liberty.

Staff understood what abuse looked like and the action they should take. Staff were trained in health and safety and staff followed the infection control procedures. Staff respected people’s human rights. Staff gained people's consent before they were supported.

People were supported with their medicines and their nutritional needs were met. People were supported with their health care needs when required. The service worked with other organisations to ensure that people received coordinated care and support.

There were enough staff to meet people’s needs. People felt staff treated them with care and kindness. Staff knew people well; understood their wishes and diverse cultural needs. People’s dignity and privacy was respected.

Staff had a good understanding of people's needs, and their preferences and daily routines despite the lack of information detailed in the care plans. Information was made available in formats that people could understand. Improvements were needed to enable staff to provide end of life care and have policies and procedures for this.

People and staff told us that the registered manager was supportive. Staff found the registered manager was approachable. People knew how to make a complaint. The provider had a process to respond to complaints but not all complaints were logged centrally.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of this report.

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any re