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Archived: Leader Care

Overall: Inadequate read more about inspection ratings

Airedale House Business Centre, 423 Kirkstall Road, Leeds, LS4 2EW 07484 101038

Provided and run by:
Leader Care Ltd

Important: We are carrying out a review of quality at Leader Care. We will publish a report when our review is complete. Find out more about our inspection reports.

All Inspections

26 April 2021

During an inspection looking at part of the service

About the service

Leader Care is a domiciliary care service. It is registered to provide personal care to people living in their own homes in the community.

Not everyone who used the service received personal care. The Care Quality Commission (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, three people were receiving a personal care service.

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

The provider was failing to effectively assess, monitor and improve the quality and safety of the service and 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.

Information relating to people's individual risks were not always recorded or mitigated and did not provide enough assurance that people were safe. Suitable arrangements were not in place to always ensure the safe management of medicines and this placed people at risk of harm.

Lessons were not consistently learned to improve the quality of care for people using the service. The provider's response to the COVID-19 pandemic was inconsistent and increased risks to people's health. Appropriate measures were not in place to prevent and control the spread of infection.

Recruitment procedures were not always robust enough to ensure suitable people were employed. Staffing levels were maintained. However, changes to calls were made without discussion with people and there was no analysis of missed or late calls to prevent them happening again.

A person and a relative we spoke with were satisfied with the care and support they or their family member received from individual staff. They described staff as kind and caring. However, they said arrangements to communicate with them were not effective; for example, they did not know which staff were coming to provide their care. Care plans covered people's individual care and support needs. Improvements were still required to ensure each person's care plan was up to date and accurate.

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 17 December 2020) and there were multiple breaches of regulation. The provider told us after the last inspection what they would do to improve. At this inspection we found insufficient improvement had been made and the provider was still in breach of regulations.

Why we inspected:

This was a planned inspection due to an increasing number of concerns being raised with us about the safety, management and leadership of the service and to follow up on action we told the provider to take at the last inspection. The inspection was focused on the key questions of Safe and Well-led. 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.

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

The overall rating for the service remains Inadequate. This is based on the findings at this inspection.

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.

At this inspection we have identified continued breaches of regulations in relation to the assessment and management of potential risks to people's safety; medicines management; infection prevention and control; recruitment; staffing; governance and leadership of the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up:

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.

Special Measures:

The overall rating for this service is ‘Inadequate' and the service therefore remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the registered person's registration, we will re-inspect within 6 months to check for significant improvements.

If the registered person has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the registered person from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we re-inspect it and is no longer rated as Inadequate for any of the five key questions, it will no longer be in special measures.

3 September 2020

During a routine inspection

About the service

Leader Care is a domiciliary service providing personal care to 41 people.

People’s experience of using the service

Risk assessments were not always completed or robust. We found assessments had not been completed when there was documentation to suggest a risk was present. Medicines were not managed safely as poor documentation meant we were unable to determine if all medicines had been given. We also found medication stock counts were incorrect.

Staffing levels were sufficient however, visits were often missed or late. Recruitment procedures were not effective as some staff had started working prior to relevant checks being carried out. The provider had not always investigated or taken action from safeguarding incidents and concerns related to risk, to protect people who used the service from harm.

Staff were not provided with the relevant training to meet peoples specific care needs. The induction procedure did not include any face to face training and induction books had not always been completed prior to staff starting work. Staff were not provided with regular supervisions or spot checks to check their competencies.

The provider failed to assess, monitor and improve the quality of the service and maintain accurate and robust care records. We found shortfalls in recordings; for example, Medication Administration Records (MARs), care plans and risk assessments were not always signed, updated or completed.

Audits had not been carried out on a regular basis to ensure oversight and monitoring of the service. There was no evidence of analysing trends or themes within the service to prevent against possible risks and improve care.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the systems in the service did not support this practice. We have made a recommendation about the Mental Capacity Act within the report.

Care plans were in place but not always updated to reflect peoples' current needs and related risks. People and their relatives were involved in their care planning. End of life care plans were in place, but they did not always identify people’s preferences and choices.

Complaints were recorded however, the actions recorded as taken had not always been completed.

People and their relatives told us the staff were caring and polite. People’s dignity had not always been respected. People and their relatives told us communication with the office was poor.

Staff were aware of infection control practices in relation to the latest COVID-19 government guidance for the use of Personal Protective Equipment (PPE) to keep people and staff safe. However, staff told us they had not received any specific training in relation to PPE during the COVID pandemic.

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

Rating at last inspection

This service was registered with us on 07/06/2019 and this is the first inspection.

Why we inspected

This was a planned inspection. The inspection was prompted in part due to concerns received about overall care quality and safeguarding concerns.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively

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

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 five breaches in relation to safe care and treatment, staffing, safeguarding, fit and proper persons and governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.