Lovage Homecare Ltd

Lovage Homecare Ltd provides personal care to people, inducing older people living in their own homes. There were 7 people using the service at the time of our inspection.

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

The systems in place to monitor the care people received were not consistently completed. When completed they did not always identify areas of improvement or demonstrate the actions taken.

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

There were enough suitably recruited staff available to support people and they were happy with the care they received. Staff have received training and a new induction process had been introduced.

Risks to people were considered and reviewed, when needed. Infection controls procedure where in place and followed. People received their medicines when needed.

Staff felt supported and listened to. Feedback was sought from people who used the service, and they were involved with their care and reviews.

People were supported with mealtimes when required and their needs were now assessed. When needed supported was offered with people’s health.

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 2 June 2023)

At this inspection we found some improvements had been made and the provider was no longer in breach of some regulations. The provider remained in breach of other regulations.

This service has been in Special Measures since 20/01/2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of 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 Lovage Homecare Ltd. on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to MCA and how the service is governed.

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 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.

Lovage Homecare Ltd is a domiciliary care agency providing personal care to people in their own homes. The service provides support to older people. At the time of our inspection there were 9 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

People were placed at risk of harm because the provider failed to effectively assess and manage risks. Systems used for the safe management of medicines were not established and there was no oversight of medicines administration. People were supported by staff who had not been safely recruited as the provider failed to establish effective systems and checks to ensure they were safe to work with people. The provider failed to notify CQC of safeguarding allegations as required by law.

People were placed at risk because the provider had not ensured staff had received an induction and training relevant to their role. Where people received support with their mobility the provider had failed to ensure their competency had been checked to reduce the risk of avoidable harm. The provider had failed to act in accordance with the Mental Capacity Act (MCA) which placed people at risk of having decisions made without their consent.

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 policies and systems in the service did not support this practice.

People’s care was not planned to ensure staff received guidance on how to provide people with caring, dignified support. Care plans failed to identified people’s individual preferences and were generic in nature. People’s needs had not been fully assessed and the provider had failed to carry out reviews of people’s care to ensure it met their current needs. Planning for people who were at the end of their lives was limited and did not reflect people’s individual wishes.

The provider had failed to establish governance systems to monitor the quality of care people received. The registered manager and nominated individual were not aware of their responsibilities as registered persons and had failed to ensure people’s care was planned safely to meet their individual needs. Most people and relatives were unaware of who managed and led the service, which meant they did not always know how to offer their feedback.

People received support from staff at the time they needed it and were notified of any delays in support calls. Staff used PPE in accordance with the provider’s infection control policy and the provider had made changes in response to incidents and events to reduce the likelihood of reoccurrence.

People spoke positively about the support they received and the provider had responded appropriately to complaints about the service. Staff felt supported by the nominated individual and felt their feedback was considered and taken seriously 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

This service was registered with us on 20 May 2022 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about medicines and poor quality care. A decision was made for us to inspect and examine those risks.

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

Enforcement

We have identified breaches in relation to consent, medicines management, management of risk, poor governance, staff training, unsafe recruitment practices and failure to notify of significant events at this inspection.

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 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.

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.