LlyonHealth

Updated 6 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 team was carried out by 2 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 this type of care service.

Service and service type

This service is a domiciliary care agency. It currently provides personal care to people living in their own homes.

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. The registered manager was also the owner of the provider organisation. The registered manager was not available for the 2 days we visited their office.

Notice of inspection

We gave the service 24 hours’ notice of the inspection visit. 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 and we wanted to be able to speak with the person who received the service.

Inspection activity started on 3 May 2023 ended on 25 May 2023. We visited the location’s office on 3 and 19 May 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 and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with 2 people who used the service and 5 relatives. We spoke with the registered manager on the telephone, care co-ordinator, team leader and 8 members of the staff team. We visited the office and looked at records related to 2 people’s care, and the oversight and management of the service. This included 4 staff files, training records, risk assessments, and audits.

Updated 6 July 2023

About the service

LlyonHealth provides personal care to people living in their own homes. Not everyone supported by 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 the inspection the service was providing personal care to 14 people.

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

Staff continued to not be recruited safely, with gaps in employment histories and references not always being completed. This meant people were potentially at risk of staff being employed to work with them who were not suitable.

Improvements had been made to call times and we received no reports of missed calls. However, we received mixed feedback from people and their relatives that call times were not always exact. However, we found the majority of the calls deemed late, were within the thresholds set by the local authority.

At this inspection staff morale was considerably low, with many staff speaking out to raise issues around their holiday pay entitlement and travel time pay. We have also shared their feedback with the local commissioning team.

Staff told us they received regular training, but for many staff the majority of their training had been completed at other care companies they had worked for prior to joining LlyonHealth. We were not assured the registered manager has assessed these new staff members competency levels, there was an overreliance these staff members had the sufficient skills to provide safe care and treatment.

The provider had implemented a new governance framework at the service. However, these systems and processes to ensure oversight of the safety and quality of the service were not always effective. Audits completed had not always identified the concerns we found on inspection. At this inspection there was an overreliance on office staff to complete a number of quality checks.

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

The last rating for this service was requires improvement (published 24 October 2022).

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements.

This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for LlyonHealth on our website at www.cqc.org.uk.

Enforcement and recommendation

We have identified breaches in relation to staffing, safeguarding, training and governance at this inspection.

We have made a recommendation about the escalation of safeguarding concerns.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.