Lily Health Care Limited

Updated 8 December 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 undertaken by 1 inspector and an Expert by Experience who undertook telephone calls. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Lily Health care limited 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 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 09 November 2023 and ended on 16 November 2023. We visited the location’s office on 09 and 13 November 2023. Telephone calls were undertaken to people and their relatives on 08 November and 16 November 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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service and 2 relatives to gain their feedback about their experiences of using the service. We spoke with 5 staff which included care staff, deputy manager and the registered manager who is also the provider. We reviewed and sampled a range of documents and records including the care and medicine records for 4 people, and 3 staff recruitment files. We also looked at records related to the management and quality assurance of the service.

Updated 8 December 2023

About the service

Lily health Care limited is a domiciliary care service providing personal care to people who live in their own homes. The service is registered to support people with a variety of needs including people who live with dementia, people with physical disabilities, older people, people with a learning disability and autistic people. At the time of the inspection the service was supporting 12 people. Some people were supported by care staff who lived in at people’s homes and provided 24 hour support to people 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.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support:

Staff supported people with their medicines, however records needed improving to ensure they were accurate and completed in full without any gaps. Risks to people were not always assessed and those in place required more detail with actions for staff to follow. People were supported by a consistent staff team who knew them well and understood their needs.

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.

Right Care:

Staff protected and respected people's privacy and dignity. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff promoted equality and diversity. They understood people's cultural needs and provided culturally appropriate care.

Right Culture:

The provider needed to implement effective systems and processes to monitor the quality of the service and to drive improvement. Audits in place were not always effective in identifying shortfalls.

The provider had not always submitted notifiable incidents in accordance with their legal responsibilities. Immediate action was taken to address this shortfall.

People and those important to them, were involved in planning their care. The registered manager was open and transparent throughout our inspection and demonstrated a commitment to delivering improvements and achieving best outcomes for people. They were receptive to our feedback and took action to address the shortfalls we found.

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 the service was good (published 07 December 2016).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well led key question sections of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to the management of risk and how the provider monitors the service provided.

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

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.