Background to this inspection
Updated
17 June 2021
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 Care Act 2014.
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 their own houses and flats.
The service had a manager registered with the Care Quality Commission. 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. The registered manager and provider roles are carried out by the same person.
Notice of inspection
This inspection was announced.
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 May 2021 and ended on 14 May 2021. We visited the office location on 12 May 2021.
What we did before the inspection
We reviewed the information we had received about the service since registration. We sought feedback from the local authorities that work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke to the relatives of two people who use the service about their experience of the care provided. It was not possible to speak to people who use the service directly due to the difficulty using the telephone and restrictions on visiting people in their home due to COVID. We spoke with four members of staff.
We reviewed a range of records. This included two people’s care records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
17 June 2021
About the service
Luna Healthcare is a domiciliary care agency providing personal care to two people aged 65 and over at the time of the inspection.
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
At this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to good governance and fit and proper persons employed.
The providers systems were not robust, and people’s identified risks were not always managed well, such as the care of people's skin. Records did not always provide guidance to ensure people received safe and consistent, person-centred care from all staff. Systems were not always in place to ensure that people received their medicines in a safe way.
The provider did not have a quality assurance framework to assess the standards of care in the service. The informal processes in place had not identified the improvements required found at this inspection.
People said they felt safe with their care and support and with the staff. .
Staff said they felt supported by the provider and were aware of their responsibilities to share any concerns about the care they provided.
People received person-centred care from their regular care staff.
People and relatives spoken to were complimentary about the care provided by staff. People trusted the workers who supported them. People said staff were kind, caring and went above and beyond for them and their families.
People had the opportunity to give their views about the care, but there were no records to evidence this. There was consultation with staff which had lead to an improvement in people’s care records. This made it easier for new carers to understand peoples needs quickly.
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
This service was registered with us on 24 July 2018 and this was the first inspection.
Why we inspected
This was a planned inspection as the service was previously unrated.
We have found evidence the provider needs to make improvements. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe, Effective, Responsive and Well Led sections of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to the management oversight of care and the checks carried out before people start work at the service during this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for 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. If we receive any concerning information we may inspect sooner.