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Inspection carried out on 5 November 2019

During a routine inspection

About the service

Life Care Plus Limited provides care at home to people. They provide the regulated service of personal care to both younger and older adults some of whom are living with dementia and may have mental health or learning disabilities support needs.

However 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. At the time of our inspection eight people received the regulated service.

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

The provider took steps to ensure staff previous work practice was appropriate and safe. However, a risk assessment was not written to reflect the safety measures taken when a reference could not be obtained. The provider's quality assurance system had not identified this shortfall.

The registered manager used systems to ensure they had an oversight of staff practice and undertook spot checks. They checked staff administration of medicines and addressed any concerns with staff.

Staff were provided with training to support them to undertake their role.

People and relatives spoke positively about the care workers. They described them as experienced and friendly. They told us care workers usually arrived on time and communicated well with people.

The registered manager met people to assess their support needs prior to offering a service. This assessment informed people’s person-centred care plans outlined how they wanted their care to be provided.

The registered manager also assessed risks to reduce the likelihood of harm to people and made suggestions to promote people’s safety 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 and in their best interests; the policies and systems in the service supported this practice.

The registered manager and care workers supported people to access appropriate health and social care for their well-being. They followed health professionals’ recommendations.

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 requires improvement undertaken on the 9 September 2018 (published on 6 November 2018). At that inspection we found two breaches of the regulations in fit and proper persons employed and good governance.

The provider completed an action plan after the last inspection to show what they would do by January 2019 to improve.

At this inspection, not enough improvement had not been made. This was because although improvements in auditing and oversight had been made there were still some shortfalls in the recruitment process.

Why we inspected

This was a planned inspection based on the previous rating.

We found no evidence during this inspection that people were at risk of harm

Please see the sections of this full report.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 14 September 2018

During a routine inspection

This announced inspection took place on 14 September 2018. This was the service first inspection since they were registered with the CQC in September 2017.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. The service is registered with the CQC to provide a service to older adults some of whom might be living with dementia and younger adults who have learning disabilities, autistic spectrum disorder, or mental health needs.

Not everyone using Life Care Plus Limited 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 take into account any wider social care provided. At the time of our inspection three people were receiving the regulated activity.

One of the directors of the organisation was the registered manager and nominated individual. 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.

At this inspection we found that the service was rated requires improvement overall and in the key questions ‘Is the service safe?’ and ‘Is the service well-led?’ They were rated good in the key questions ‘Is the service effective, caring, and responsive?’.

The provider had undertaken criminal records checks and proof of identity for new staff. However, we found that they were not always waiting for staff references to be received from former employers before staff commenced their role. This meant that they had not verified staff work history and had not fully confirmed that they were of good character before they were employed.

The care staff were not completing medicine administration records appropriately. They did not always have clear guidance to ensure they understood when a medicine should be administered. This had not been identified by the registered manager through their audits and checks.

The provider ensured there were enough staff employed to complete people’s care calls and relatives told us there were no missed calls and staff were punctual.

Relatives and people told us they were introduced to staff before a service commenced so they were familiar with the staff and described staff as caring and thought some were “excellent.”

Staff described promoting people’s independence to maintain their dignity and self-respect.

The registered manager met with people and their relatives prior to the agreeing to provide a service. They did this to assess people’s care needs, identify risks and agree a call schedule. People had person centred plans that contained information about them and stated how they communicated, their diversity support needs and how they wanted their care provided.

Relatives told us they felt comfortable raising concerns and thought if they complained the registered manager would address their complaint.

The provider had a vision for the future and was putting systems in place so they could increase the service they offered to people.

We found two breaches of the regulations in Fit and proper persons employed, and Good governance.

You can see what action we told the provider to take at the back of the full version of the report.