Loyal Care Consortium Limited

Loyal Care Consortium Ltd is a domiciliary care agency providing care and support to people in their own home. At the time of our inspection there were 119 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.

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

Risks in relation to people receiving care and support were not always assessed comprehensively and lacked information on how to manage risks. Care plans lacked detail how people’s individual care needs were best met and were not person centred. There was little evidence that lessons were learned from accidents and incidents and the quality assurance system showed evidence of not being fully effective to highlight and respond to the concerns we have found during this inspection. People’s assessed needs were not always reflected in people’s care plans to ensure and maintain consistent care to people who used the service. The service lacked some understanding to support people to have maximum choice and control of their lives.

The service ensured that staff was recruited safely, and systems were in place to monitor and assess staff attending care calls at the time arranged in people’s care plans. The service had sufficient staff deployed to meet people’s needs. People who used the service were protected from harm and abuse and systems were in place to ensure that this was actioned and responded to appropriately. The service followed safe infection control practice to minimise the risk of the spread of infections.

Care staff had access to training, providing them with the right skills and knowledge to support people who used the service. Staff told us that they received formal and informal support and help from the management and office staff. Staff supported people in the least restrictive way possible and in their best interests.

The service had systems to respond, act and resolve complaints and concerns received from people, relatives and external stakeholders.

The management demonstrated willingness to make improvements to the care and the quality of service provisions for people who used 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 good (published 17 January 2019).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

Enforcement and Recommendations

We have identified breaches in relation to the management of risk, effectiveness of governance and quality assurance and assessment of people’s capacity and planning of care people who used the service received.

We have made recommendations for the provider to seek further guidance and information from a reputable source about involving people in decisions about their care who lack capacity and the Accessible Information Standard (AIS).

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

Since the last inspection we recognised that the provider had failed to display the rating. This was a breach of regulation and we issued a fixed penalty notice. The provider accepted a fixed penalty and paid this in full.

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 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 service is a domiciliary care agency. It provides personal care to adults living in their own homes with physical, mental health or learning disability needs.

The service registered with the Care Quality Commission on 3 January 2018. This is the first inspection of the service. At the time of the inspection the service had two people using the service who received support with personal care.

The service had a registered manager in post. 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.

Relatives told us they were happy with the care provided and staff were kind to their family members. Staff understood their role in safeguarding adults and were able to tell us what they would do if they had any safeguarding concerns.

There were care records in place but they did not contain enough detail on people’s needs. Risk assessments were not always in place to guide staff and minimise harm for all identified risks.

Relatives told us their family members were cared for by regular staff who understood their needs. Staff were on time or the office notified family members if staff were running late. Staff told us that travel times were sufficient, so they were not rushed.

At the time of the inspection family members supported people with their medicines so staff did not provide medicines support. Staff had been trained in giving medicines. The service worked with healthcare services to deliver effective care and support to people.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The registered manager and provider carried out audits to check the quality of the care provided. The service learnt lessons and made improvements when things went wrong.

There was a complaints process in place and relatives told us they knew how to make a complaint, and that the registered manager would respond to issues they raised.

Staff recruitment was safe and staff were supported to meet people’s needs through a combination of induction, supervision, training and guidance from family members.

Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection. Supplies were delivered to people’s houses.

We have made a recommendation to the service to review records to record mental capacity assessments in more detail.