Liral Veget Training and Recruitment Ltd

Updated 21 July 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 two inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in supported living settings.

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 newly appointed manager/nominated individual was in the process of applying to be the registered manager. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Notice of Inspection

We originally gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the registered person would be in the office to support the inspection. However, the registered person was not available to support the inspection so we rescheduled the inspection to a later date.

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 authority who commission the care and support people receive.

During the inspection

We looked at a range of records including 4 people’s care and medicine records. We also looked at training records for 6 staff and records related to the management of the service. After the inspection, we continued to gather evidence and seek clarification from the provider. We also gathered feedback from people’s relatives and staff.

Updated 21 July 2023

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.

About the service

Liral Veget Training and Recruitment is a domiciliary care service which provides personal care to people living in supported living settings. Not everyone who used the service received personal care. The Care Quality Commission (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 18 people receiving care and support for personal care. The service is also registered to provide nursing care, however, this was not being delivered at the time of our inspection.

Right Support: The model of care did not maximise people's independence and people were not always protected from the risk of harm. Risks to people were not always identified and mitigated. People's medicines were not always managed safely. The provider's systems did not ensure staff received suitable training to ensure they had the skills and abilities to meet the needs of autistic people and people with learning disabilities. The provider did not always work in line with the MCA. We have made a recommendation about ensuring capacity assessments and best interests’ meetings are conducted.

Right Care: People's care was not always person-centred. There was limited information about how people were being supported to pursue interests and hobbies and people were not supported to acquire/maintain daily living skills. There was a lack of support towards aspirations and goals. People’s eating and drinking guidelines were not up to date.

Right Culture: The quality assurance and governance processes were not always effective as they had not identified the issues we found with care plans and risk assessments and staff training. The provider had not identified care plans and risk assessments contained out of date information. The provider was not clear about the roles and responsibilities of the service. There were processes in place to gather feedback from people and their relatives. Despite the issues we found we received mainly positive feedback from staff and relatives of people receiving care.

Rating at last inspection and update

The last rating for this service was good (published 21 January 2021).

Why we inspected

The inspection was prompted in part due to concerns we received about allegations of abuse which is currently being investigated by the safeguarding team. This inspection was carried out to seek assurance that people were being protected from harm.

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. Please see the safe, effective, responsive and well-led sections of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to safeguarding, the management of risks and medicines, staff training, good governance and person-centred care. You can see what action we have asked the provider to take at the end of this full report. We have also made recommendations about conducting capacity assessments/best interests’ meetings, staff recruitment and ensuring people have health action plans.

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.