Background to this inspection
Updated
14 March 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
Inspection activity started on 19 January 2023 and ended on 31 January 2023. We visited the location’s office on 19 January 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used information gathered as part of monitoring activity that took place on [date(s)] to help plan the inspection and inform our judgements. We used all this information to plan our inspection.
During the inspection
We spoke with 2 relatives about their experience of the care provided from the service. We spoke with 7 members of staff including the registered manager, senior care workers and care workers. We reviewed a range of records. This included 2 people's care records, 1 medication record, 3 staff files and a variety of records relating to the management of the service, including policies and procedures.
Updated
14 March 2023
About the service
Limitless Healthcare Services Ltd is a domiciliary care service registered to provide personal care to people who live in their own homes. At the time of our inspection there were 2 people receiving personal care and support.
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
Governance systems in place to ensure the safety of people were not effective or robust. Auditing systems did not identify improvements required at the service. Accidents and incidents were not recorded to show they were reviewed to support staff to learn lessons and mitigate reoccurrence. The provider was not proactively monitoring or recording the improvements required at the service.
People were not always safe. People were at risk of harm as the provider did not have appropriate systems in place to support safeguarding processes. Medicines management was not always safe. We could not be assured people received their medicines as directed as prescriber's instructions were not recorded.
Staff completed appropriate care plans and risk assessments for people. However, information contained within these did not reflect person centred information consistently for all people. Risks related to people’s health conditions were not always identified, mitigated and recorded.
People were supported by kind and caring staff. Staff understood their roles and responsibilities to support people in a person-centred manner. Relatives were happy with the support provided and were confident the registered manager would appropriately respond to any concerns raised.
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.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 21 April 2022 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about safeguarding people, recruitment of staff and people’s care and support. 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 and Recommendations
We have identified breaches in relation to safe care and treatment, safeguarding and good governance at the service at this inspection. Please see the action we have told the provider to take at the end of this report.
We have made recommendations for the provider in relation to accessible communication for people.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.