Archived: Lillyfields Care

Updated 2 November 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 12 and 13 October 2016 and was announced. The provider was given 48 hours notice because the location provides a domiciliary care service. The provider ensured that people were available to speak with us on the day of the inspection. The inspection was carried out by two adult social care inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses care services.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help us decide what areas to focus on during our inspection. We reviewed all the information we held about the service including previous inspection reports and notifications received by the Care Quality Commission. A notification is information about important events which the provider is required to tell us about by law.

During our inspection we spoke with 19 people and five relatives. We also spoke with the provider, the operations manager, the manager, the care co-ordinator, the Human Resources officer and nine care workers. We reviewed records relating to the management of the service, such as audits, and reviewed three staff records. We also reviewed records relating to ten people’s care such as their care plans and risk assessments.

We last inspected this service on 18 September 2014 and found a breach of regulations.

Updated 2 November 2016

The inspection took place on 12 and 13 October 2016 and was announced.

Lillyfields Care provides a domiciliary care service for people living in Petersfield and the surrounding area. At the time of the inspection 60 people were receiving care visits.

Lillyfields Care is not required to have a registered manager in post. This is because the provider is an individual person who acts as a registered manager as well as the registered provider. 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.

At the last inspection on 18 September 2014 we found a breach in regulations. We asked the provider to take action to make improvements to the implementation of the principles of the Mental Capacity Act 2005. As a result of the breach, the provider sent us an action plan detailing how they would ensure the regulations were being met. We found this action had been completed fully.

People were asked for their consent before care or treatment was provided. Staff told us they asked people for their consent before providing any care. The provider had taken action to ensure that those people who did not have capacity to consent to their care were identified and that they followed the principles of the Mental Capacity Act 2005 (MCA) when providing care.

People were protected from abuse. Staff had knowledge and confidence to identify safeguarding concerns and acted on these to keep people safe. There was a safeguarding policy which was available to staff. This detailed the action staff should take in these events along with contact telephone numbers for the relevant authorities where they could seek advice and report concerns.

Risks to people’s personal safety had been assessed and plans were in place to minimise these risks. Assessments were carried out before people accessed the service to identify any potential risks to their safety. Care plans were written which addressed the risks so that staff were informed about how to provide care in a way which protected people.

People were supported by sufficient staff with the right skills and knowledge to meet their individual needs. The allocation of staff was carried out part electronically and part manually. The system ensured consistency of staff for people, identifying appropriate travel routes and provided sufficient travel time. The system ensured that any shortfalls in availability of staff could be identified and recruited to. This ensured there were always enough staff available to cover all calls.

Recruitment and induction practices were safe. Relevant checks such as identity checks, obtaining appropriate references and Disclosure and Barring Service (DBS) were being completed for staff. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.

There was a system in place to ensure the safe administration of medicines. Some people had their medicines administered by staff. Staff had received training to ensure they were able to administer medicines safely. Information was recorded in people’s care plans which informed staff where medicines were kept in people’s homes and how to administer them.

Staff had received appropriate training to meet people’s needs. Records showed that staff had received training in key areas such as infection control, fire training, moving and handling, food safety and health and safety. Staff told us they had received sufficient training to meet the needs of people. Staff received an induction in line with the Care Certificate.

Staff had regular supervision meetings with management and an annual appraisal. Staff received extra supervision and appraisal during their induction period. Records showed that staff were regularly checked for their competency in delivering care.

The service liaised with community health care professionals to ensure that people were able to access services in relation to their health needs and that there was good communication to support people’s needs.

Relatives and people were happy with the care provided and thought that staff were kind and caring.

Staff respected people’s dignity. Staff described how they protected people’s dignity by closing curtains and doors and covering people with towels when they were washing them. People were supported to be as independent as possible. Care staff told us they always offered people the opportunity to do things for themselves. They supported people where they were unable to do things for themselves.

People were involved in decisions about their care and were offered choices. People told us they and their relatives had been involved in their plan of care and had participated in six monthly reviews.

People had care plans that clearly explained how they would like to receive their care and support. Care plans were regularly updated and amended where necessary to meet people’s changing needs. Care plans included an assessment of people’s needs and were written to reflect people’s individual needs and wishes. Staff were knowledgeable about people’s needs and preferences. They told us they had read and understood care plans and ensured they followed them.

The provider responded to feedback, concerns and complaints. The management team sought feedback from people using the service to ensure they were happy with the service. Any concerns or complaints were investigated, managed and resolved quickly.

The provider had a complaints procedure. Details of this were included in care plans so that people and their relatives would know how to complain if they needed to. Most people and relatives contacted the office if they had any issues or concerns they wanted to discuss.

There was a positive and open culture within the service. Staff said they felt able to raise concerns, and were confident they would be responded to. People and staff were happy with the service and praised the management team.

The inspection was supported by a knowledgeable management team, who were helpful and able to provide the information requested and answer questions throughout the inspection.

The registered provider demonstrated good management and leadership, through the effective management of the service and the quality of care provided. She was supported by the management team who demonstrated they were aware of their statutory responsibilities as a provider. CQC had received appropriate notifications from the service. Policies and management arrangements meant there was a clear structure which ensured the service was effectively run and closely monitored. The provider had identified areas of the service which needed to be improved and prepared a plan to address these.

The quality of the service was monitored by management through a series of checks. Feedback was in the form of feedback surveys and care plans were checked on a sample basis every month. Staff received regular ‘spot checks’ to ensure the quality of care provided.