Leicester

Updated 9 June 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

This inspection was carried out by 1 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 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 12 April 2023 and ended on 14 April 2023. We visited the registered office on 12 and 13 April 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 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 information gathered as part of monitoring activity that took place on 9 March 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people and 2 relatives of people who used the service. We spoke to 7 staff including the registered manager, assistant manager, director, and care workers. We reviewed a range of records. This included 4 people's care records and medication records. We looked at 4 staff files in relation to recruitment, training, and support. We reviewed a variety of records relating to the governance and oversight of the service including policies and procedures.

Updated 9 June 2023

About the service

Leicester is a domiciliary care agency providing personal care and 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. At the time of our inspection there were 13 adults who received packages of support which included personal care.

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

The provider’s oversight systems and processes were not effectively used to monitor the quality of service being provided and to drive improvements. This included oversight of people's care records, monitoring staff punctuality, training and up to date operating systems including policies and procedures.

Risks to people were not always identified, managed, and monitored. Care plans were not always kept up to date and contain sufficient up to date guidance for staff to follow to keep people safe.

People told us they were safe with the staff who supported them. Staff were recruited to the service safely. Staff were trained for their role and their competency was checked. Staff were knowledgeable in safeguarding procedures and were aware of how to escalate concerns if needed. There were sufficient staff to meet people’s needs. People were supported by regular care staff who knew and understood their needs and routines. People were supported with their medicines safely where this was required.

People told us they felt safe and staff ensured they were safeguarded from harm. People were supported with their medicines when this was required. Infection prevention and control practice was followed by staff to reduce the risk of cross contamination and the risk of infection.

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 CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 4 November 2020).

Why we inspected

The inspection was prompted in part due to concerns in relation to staff recruitment. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We found no evidence during this inspection that people were at risk of harm in relation to staff recruitment. However, we have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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.

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

Enforcement and Recommendations

We have identified a breach in relation to managing risks to people and their care needs and governance systems to monitor the service at this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.