Lyfem Home Care Services UK Ltd

Updated 21 December 2022

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 Care Act 2014.

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 homes.

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 not a registered manager in post. The nominated individual had applied to be the registered manager of this service but their application had been refused. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We liaised with the nominated individual throughout this inspection and the previous inspection.

Notice of Inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the nominated individual would be in the office to support the inspection. Inspection activity started on 11 November 2022 with a visit to the office location. We continued to analyse evidence and make calls to staff until 21 November 2022.

What we did before the inspection

We reviewed information we had received about the service including complaints and notifications we received from the service. We spoke with the local authorities who commission the care and support people receive. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with the nominated individual and a supervisor. We reviewed a range of records including care and support plans for 3 people. We looked at records of recruitment for 3 staff. We looked at training data and quality assurance records. We made calls to one person receiving care and a social worker to get their feedback on the service. We also made calls to 2 care workers and a supervisor to get their feedback about the service.

Updated 21 December 2022

About the service

Lyfem Home Care Services Ltd is a domiciliary care service which provides personal care to people living in their own homes. 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. At the time of the inspection there were four people receiving care and support for personal care.

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

We found ongoing issues with the management of safety. Risks were not always assessed, and care plans lacked essential detail on how risks should be mitigated. People’s medicines were not always managed safely. Medicines support in care plans was not in line with current best practice guidelines. Care plans contained inaccurate information about the level of support people needed to take their medicines. The provider did not always follow safe recruitment processes.

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. The provider did not ensure consent to care was gained appropriately from the relevant person.

The provider had made some improvements since the last inspection. There were spot checks and supervision of staff. Despite improvements the quality assurance systems were not sufficiently robust and had not identified the ongoing issues we found with risk management and recruitment. Care records and medicine records were not checked by a senior member of staff to identify issues. The provider was not complying with the conditions of the registration as they had not informed us they had moved office.

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 requires improvement (report published 7 January 2022)

and there were breaches of regulation. Although we found some improvements at this inspection the provider remained in breach of several regulations.

Why we inspected

We undertook this inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met and whether the provider had made the improvements set out in their action plan. At this inspection we found the provider had not made sufficient improvement and the overall rating for the service remains requires improvement.

This focused report covers the entirety of the key questions Safe and Well-Led and part of the key question Effective. Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating 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 have identified ongoing breaches in relation to safe care and treatment, the recruitment of staff, consent to care and good governance. We have sent a Regulation 17(3) letter to the provider in relation to

their failure to effectively operate systems and processes to assess, monitor and improve the quality and

safety of the services provided. A Regulation 17(3) Letter stipulates the improvements needed to meet breaches of regulation, seeks an action plan and requires a provider to regularly report to CQC on their progress with meeting their action plan.

Follow up

We will meet with the provider to discuss how they will implement their action plan and make the required

changes to ensure they improve their rating to at least good. We will work alongside the provider and the

local authority to monitor progress. We will continue to monitor information we receive about the service,

which will help inform when we next inspect.