Laniwyn Care Services

Laniwyn Care Services Limited is a domiciliary care service that provides care and support to adults and children living in their own homes. At the time of our inspection there were seventeen people using the service. 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.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support: People were supported to take their medicines as prescribed. Medicine management procedures in place supported safe medicine administration. 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. There were enough staff to meet people's needs, however people did not always receive their care as planned. Safe recruitment practices were followed.

Right Care: People were supported by kind staff; however further training was required for staff to fully understand their needs. People told us they felt safe using the service. Staff understood how to protect people from harm and how to raise concerns. The registered manager understood their role and responsibilities in relation to safeguarding people. Care plans were in place however these required further detail to be person centred and risk assessments relating to people’s support required further development. People were treated with dignity and respect however a greater understanding of people’s needs through training would enable staff to better understand people and encourage them to learn new skills and participate in activities they enjoyed.

Right Culture: Systems and processes to ensure management oversight were not always effective. Records were not always accurate and did not always contain sufficient details. The registered manager implemented changes immediately after the inspection. Feedback was sought from relatives and staff who told us the registered manager demonstrated an open and transparent approach. Staff enjoyed working at the service and felt supported in their roles. The registered manager and staff worked with external professionals to drive improvement and learn lessons.

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 04 April 2020).

Why we inspected

We received concerns in relation to risk management, staffing, safe care, and management oversight of the service. As a result, we undertook a focused inspection to review the key questions of safe and well led only.

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 good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

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

Enforcement

We have identified a breach in relation to good governance at this inspection.

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

Follow up

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will follow up in a couple of months and request evidence of actions taken. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information and phone calls to engage with people using the service as part of this performance review and assessment.

Laniwyn Care Services is a domiciliary care agency providing personal care. At the time of the inspection they were supporting nine 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

People told us they felt safe and well cared for. Staff knew how to keep people safe from harm and when to raise any concerns they may have had. Sufficient numbers of appropriately recruited staff were available to meet people's needs. Risks to people's health and welfare were identified and actions taken. People received their prescribed medicines safely from staff who were appropriately trained. Staff followed the provider's infection control policy and used the appropriate protective equipment and clothing, when required.

Staff felt supported by management and received appropriate training to carry out their role. When people required support from the service an assessment was carried out, and care was provided in line with recognised good practice. People were supported to access health care services when required. Where people needed help with eating and drinking staff assisted them with this.

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 were cared for by a staff team who treated them with kindness and respect. People were involved in developing their care and their views and wishes were respected. People said staff respected their privacy, dignity and confidentiality.

People were given enough information to make their own decisions and were given choices and support to follow their routines. People and relatives felt able to raise concerns or complaints and were confident these would be responded to.

The service had an open, honest and positive culture with transparent management and leadership. Quality assurance systems were in place and were being developed further to help monitor the quality of the service and identify any areas which might require improvement. Staff told us they enjoyed working at the service and that they were supported by the management team.

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 Requires Improvement (published 19 February 2019).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Laniwyn Services Ltd provides personal care to children and adults living with a learning or physical disability in their own homes. At the time of this inspection eight people were receiving the regulated activity of personal care.

People’s experience of using this service:

People’s relatives confirmed that staff verbally sought consent prior to offering or delivering care. However, when people reached adulthood the appropriate processes were not followed to obtain consent from them.

We found that documentation relating to people’s care had not been completed, updated or reviewed. Although staff clearly knew how to care for people, this placed people at risk. Governance systems to check and monitor the quality and safety of care provided was not consistently in place. Audits did not always identify areas for improvement such as incomplete records or additional areas of training.

People’s relatives we spoke with were happy with the care provided and the staff who provided care. They told us that staff were reliable, and the support provided to their relative meant people were able to lead fulfilling lives. Key recruitment checks were obtained before new staff started work. One person’s relative said, “They are of a great help to me and [person] and have made a great positive change to my family.”

People’s relatives told us the care provided to people was safe. Staff knew how to identify and report their concerns to management. People were cared for by sufficient numbers of regular staff they were familiar with. One person’s relative said, “I feel very safe to leave them with [person] and also [person] feels safe and happy to be looked after them.”

People’s changing health needs were known to staff who provided care that met those needs safely. People’s relatives confirmed they were satisfied with how risks were positively managed and responded to. Where necessary staff sought and followed relevant advice from healthcare professionals.

People’s medicines at the time of inspection were not managed or administered by staff. Staff supported people with preparing meals and drinks in a hygienic way, using protective equipment, such as gloves and aprons.

People’s relatives and health professionals told us the quality of care provided to people was good. Staff shared a team ethos and worked well together to deliver good care, which helped people to continue to live in their own homes among their families.

People’s relatives told us the care provided was person centred and met people’s needs, choices and preferences. They told us staff supported people to maintain their independence and choices about how their care was delivered. Staff took time to support people with their interests to avoid social isolation. Everyone we spoke with felt comfortable to raise concerns or complaints and were confident that these would be dealt with.

Rating at last inspection:

Laniwyn Services Ltd was registered on 16 October 2017. This was the first inspection since the service was registered, therefore a previous rating had not been provided.

Why we inspected:

This was the first rated comprehensive inspection of Laniwyn Services Ltd carried out as a routine planned inspection.

Follow up:

We will share our findings with the local authority commissioning team. We will continue to monitor the service through the information we receive. Where this information suggests a decline in the standard of care provided we may revisit the service.