Lincolnshire Home Care Limited

Lincolnshire Home Care Limited is a care agency providing personal around 100 people at the time of the inspection. It provides support to people living around Spalding, Holbeach and Sutton Bridge.

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 using the service and their relatives were happy with the standard of care provided. They told us they received support from a small group of staff who knew their needs. Staff arrived at the planned time and had the time to support people with their care needs. The provider had recruitment checks in place to ensure staff were safe to work with people who used the service.

Staff had received training in how to provide safe care. Their ability to administer medicines safely was assessed and people were confident in the staff’s ability to use equipment safely. Staff understood their responsibility to keep people safe from harm and knew the process to raise concerns both with the provider and with external agencies.

The provider had supported staff during the COVID-19 pandemic and staff wore appropriate PPE when supporting people. However, office staff were not wearing PPE in line with guidance and systems were not in place to monitor staff’s adherence to COVID-19 testing.

We have recommended that the provider follow all infection control guidance and best practice.

The provider was continually developing the service provided. Some audits were in place and the provider had identified where more needed to be completed to monitor the service effectively.

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 (published 19 March 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The inspection was prompted in part due to complaints received about care being withdrawn from people without notice placing them at harm. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

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.

Lincolnshire Home Care Limited in Spalding, provides care and support for people in their own homes. The service was supporting 128 people at the time of the inspection. 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

Safeguarding concerns were not always identified and escalated as appropriate to the local authority. Accident and incidents had not been effectively analysed to ensure measures were put in place to reduce reoccurrence. Medicines were not managed safely. Competency assessments were not in place to show staff were competent to administer medicines to people. Care calls were periodically late and occasionally had

been missed, resulting in people not receiving the support they required. People's risks had been assessed. Staff had access to infection control equipment to reduce the risk of spread of infection. We made a recommendation about recruitment processes.

There was a lack of quality assurance systems in place to enable the management team to have full oversight of quality in the service. Quality audits undertaken had not been effective in identifying shortfalls. Some staff were not clear of their roles. Staff and people found the registered manager to be approachable and supportive. People's equality characteristics were fully considered. People's feedback was sought.

Information was available to people in different ways, so they could make informed decisions. Staff supported people's social needs and encouraged them to express themselves freely in relation to sexual orientation. Complaints were handled in line with the organisation's policy. Staff were passionate about delivering quality end of life care.

Staff had not always under taken relevant training before delivering care. People's needs had been assessed prior to care and support being delivered. Equipment to support people was available. Staff supported people to prepare meals they enjoyed. The service worked with other agencies to provide timely care. People's capacity had been assessed. We made a recommendation about staff training.

People told us staff were caring and supported them well. Staff were passionate about protecting people's dignity. People were involved in their care planning.

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

Rating at last inspection

The last rating for the service was good (published in 4 August 2017)

Why we inspected

This was a planned inspection based on the previous rating

Enforcement

We have identified breaches in relation to medicines, accidents and incidents, care calls being missed and quality assurance systems.

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 for the provider to understand what they will do to improve the standards of quality and safety. 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 return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

Lincolnshire Home Care is registered to provide care for people in their own homes. The service can provide care both for younger adults and for older people. It can also provide assistance for people who live with dementia, who have a physical disability and/or who have a learning disability. At the time of our inspection the service was providing care for 40 people, nearly all of whom were older people. The service had its office in Spalding. It mainly covered Spalding, Moutlon and Holbeach. However, it also extended to Skegness and the surrounding area for people who were receiving palliative care at the end of their lives.

The service was operated by a company. The director of the company was also the registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. In this report when we speak about both the company and the registered manager we refer to them as being, ‘the registered persons’.

The registered manager and care staff knew how to keep people safe from situations in which they might experience abuse and people had been supported to avoid preventable accidents. Medicines were managed safely and people had been helped to obtain all of the healthcare they needed. There were enough care staff to complete planned visits in the right way. However, background checks for new care staff had not always been completed correctly.

Although care staff had not received all of the training the registered persons said they needed, in practice they knew how to care for people in the right way. This included supporting people to eat and drink enough.

CQC is required by law to monitor how registered persons apply the Mental Capacity Act 2005 (MCA) and to report on what we find. The registered persons and care staff had received training in this subject and they helped people to make decisions for themselves. When people lacked the capacity to make their own decisions the principles of the Mental Capacity Act 2005 and codes of practice were followed. This helped to protect people’s rights by ensuring decisions were made that were in their best interests.

People were treated with kindness and compassion. Care staff recognised people’s right to privacy and promoted their dignity. There were arrangements in place to assist people to access independent lay advocates and confidential information was kept private.

People had been consulted about the care they wanted and they had been given all of the assistance they needed. This included people who lived with dementia and who needed extra support. Care staff recognised the importance of promoting equality and diversity by supporting people to make choices about their lives. This included choosing which interests they wished to pursue and how they wished to meet their spiritual needs. There were arrangements to quickly and fairly resolve complaints.

People had been consulted about the development of the service and quality checks had been completed. Good team working was fully promoted and care staff were supported to speak out if they had any concerns about poor practice.