Background to this inspection
Updated
3 November 2022
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. Following the inspection two Experts by Experience called people who use the service and their relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. An additional inspector contacted care workers and asked them about their experience working for Loyal Care Consortium Ltd.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post. However, the registered manager was not available during our inspection and we were assisted by the operations director.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 8 September 2022 and ended on 13 September 2022. We visited the location’s office on 8 September 2022.
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 nine people who used the service and 10 relatives to get their views about the care and support received. We spoke with 12 staff, including the operations director, care coordinators and care workers.
We viewed care records for eight people who used the service and multiple medication records. We viewed five staff recruitment records We looked at a variety of records relating to the management of the service, including policies and procedures.
Updated
3 November 2022
About the service
Loyal Care Consortium Ltd is a domiciliary care agency providing care and support to people in their own home. At the time of our inspection there were 119 people using the service. 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
Risks in relation to people receiving care and support were not always assessed comprehensively and lacked information on how to manage risks. Care plans lacked detail how people’s individual care needs were best met and were not person centred. There was little evidence that lessons were learned from accidents and incidents and the quality assurance system showed evidence of not being fully effective to highlight and respond to the concerns we have found during this inspection. People’s assessed needs were not always reflected in people’s care plans to ensure and maintain consistent care to people who used the service. The service lacked some understanding to support people to have maximum choice and control of their lives.
The service ensured that staff was recruited safely, and systems were in place to monitor and assess staff attending care calls at the time arranged in people’s care plans. The service had sufficient staff deployed to meet people’s needs. People who used the service were protected from harm and abuse and systems were in place to ensure that this was actioned and responded to appropriately. The service followed safe infection control practice to minimise the risk of the spread of infections.
Care staff had access to training, providing them with the right skills and knowledge to support people who used the service. Staff told us that they received formal and informal support and help from the management and office staff. Staff supported people in the least restrictive way possible and in their best interests.
The service had systems to respond, act and resolve complaints and concerns received from people, relatives and external stakeholders.
The management demonstrated willingness to make improvements to the care and the quality of service provisions for people who used the service.
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 17 January 2019).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding.
Enforcement and Recommendations
We have identified breaches in relation to the management of risk, effectiveness of governance and quality assurance and assessment of people’s capacity and planning of care people who used the service received.
We have made recommendations for the provider to seek further guidance and information from a reputable source about involving people in decisions about their care who lack capacity and the Accessible Information Standard (AIS).
Please see the action we have told the provider to take at the end of this report.
Since the last inspection we recognised that the provider had failed to display the rating. This was a breach of regulation and we issued a fixed penalty notice. The provider accepted a fixed penalty and paid this in full.
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.