Lotus Home Care Wakefield

Lotus Home Care Wakefield is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection the service was providing personal care to 115 people, this included older people, people living with dementia and physical disabilities.

Not everyone who used the service received personal care. 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.

People’s experience of using this service and what we found

Risks to people’s safety were not always adequately assessed. There were enough staff to meet people’s needs safely, but not always to achieve consistency for people.

People and their relatives consistently told us they received safe care. Staff knew how to recognise and report abuse. Staff were trained to administer medicines safely and were assessed regularly to make sure they were competent. People were protected from the risk of infection and they told us staff wore PPE in their homes.

Staff received regular supervisions and ongoing training, to ensure they had the right knowledge to support people effectively. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People spoke positively about the care they received from staff.

The provider regularly sought feedback from people and input from staff, which was analysed by the registered manager in order to continuously drive improvement. The provider had robust governance arrangements in place, to assess the quality of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 29 September 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We carried out an announced focused inspection of this service on 16 March 2021. Breaches of legal requirements were found in respect of safe care and treatment, good governance and staffing. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check to check whether the Warning Notices we previously served in relation to Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations 17 and 18. However, the provider remained in breach of regulation 12.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lotus Home Care Wakefield on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to safe care and treatment at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Lotus Home Care Wakefield is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection the service was providing personal care to 168 people.

Not everyone who used the service received personal care. 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.

People’s experience of using this service and what we found

The provider and registered manager were failing to effectively assess, monitor and improve the quality and safety of the service and failing to assess and manage a range of potential risks to people's safety and welfare. The leadership, management and governance arrangements did not provide assurance the service was well-led. Quality assurance and governance arrangements had not been reliable or effective in identifying shortfalls in the service. Risk assessments and moving and handling assessments were sometimes missing or out of date. People’s care plans were not always updated when their needs had changed and contained contradictory information regarding their support needs. People told us they received care from a variety of staff with sometimes no consistency as to which staff would arrive to support them. Staff told us their rotas were sometimes unmanageable with little planned scheduled breaks. People told us they felt safe, however, a relative spoke less positively regarding safety after staff visited. Staff were recruited safely.

People and their relatives felt their concerns were not always addressed satisfactorily by the senior management team. Some care staff told us they felt the office staff did not listen to them or act on information they provided regarding people’s changing needs. Care staff spoke positively about the care they provided to people and their job role. One member of staff told us, “Every single client is telling us we’re doing a really good job.” People and their relatives spoke positively about the care staff. One relative told us, “If [Person] is happy, then I’m happy.”

People were not supported to have maximum choice and control of their lives and staff did not supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

We have made a recommendation about the Mental Capacity Act.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 26 October 2018).

Why we inspected

We received complaints and whistleblowing concerns in relation to peoples care needs and late call times. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lotus Home Care Wakefield on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to assessing risk, safety monitoring and management, staffing and good governance at this inspection.

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.

We completed a comprehensive inspection. 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 adults. At the time of inspection, the service was supporting 40 people with a personal care service.

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.

People and their relatives told us they did not always have the same staff who supported them in their home and sometimes came to their home early or late. We spoke with the registered manager who told us that the home had a call monitoring process in place which showed times of all staff calls which we saw evidence of on inspection.

Staff were trained in the principles of the Mental Capacity Act (2005), and could describe how people were supported to make decisions.

Staffs competency was assessed before they worked with people and periodically during their employment. Staff, people and their relatives told us they could speak to the registered manager if they had any concerns. The registered manager carried out formal supervisions and visual observations with all staff. We saw staff received an annual appraisal. We saw staff meetings took place.

People told us they felt safe with the care and support they received from staff. Staff were aware of safeguarding procedures and how to follow these. Staff had completed an induction and was allocated to support people in relation to their care and cultural needs.

Staff were sufficiently trained and knowledgeable about their roles and responsibilities.

People told us they were supported to eat and drink. Staff supported them to healthcare appointments and provided personal care as required to meet people’s needs.

Medicines were managed, stored and administered safely.

There was a complaints procedure in place. People who used the service, their relatives and staff knew how to complain. Complaints and compliments were dealt with in accordance with the agency policy.

Accidents and incidents were recorded and trends and patterns were analyses by the registered manager.

There were systems in place to assess and monitor the quality of the service. Staff said there were good leadership within the service which promoted an open culture.