Leda Homecare

Updated 10 June 2020

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 conducted 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.

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 11 March 2020 and ended on 13 March 2020. We visited the office location on 11 and 13 March 2020.

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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make.

This information helps support our inspections. We contacted Healthwatch, this is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with nine people who used the service and four relatives about their experience of the care provided. We spoke to seven members of staff, including, the registered manager, deputy manager, care coordinators, team leaders, care staff and administration staff.

We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision and competency assessments. A variety of records relating to the management of the service, including policies and procedures and audits were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. The provider provided us information on staff training, policies and procedures, the business plan, complaints, computerised care plans and documentation, this information was included in the inspection.

Updated 10 June 2020

About the service

Leda Homecare is a domiciliary care agency, providing personal care to 90 people at the time of the inspection. 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

People were not always protected from harm, as safeguarding concerns were not always reported or analysed in an effective way. Staff and management knowledge of how to report safeguarding events was poor. Some staff had out of date safeguarding training.

There were risk assessments in place, however these were not always clear or comprehensive and not all risks had been identified or mitigated effectively.

There were gaps in medicine charts, so we could not be assured that people received their medicines in a safe way.

Several staff had training that was out of date, which meant staff did not necessarily have the training to support people in a suitable way. People were protected from the risk of infection.

Staff were recruited safely, and on most occasions, there were enough staff to meet people’s needs. However, both staff and people who used the service gave examples of times there were not enough staff, and relatives had to provide care.

Staff were kind and caring and respected people’s privacy and dignity. People told us staff treated them with respect. Staff were flexible around people’s social needs.

People’s needs were assessed, however there was a lack of nationally recognised tools to support initial and continuous assessment. Information gathered, around people’s wishes at the end of their life was basic.

Staff and management knowledge of the Mental Capacity Act was limited, and we could not be assured the service was working within the Act.

Complaints were not always handled in an appropriate way following the complaints policy.

Due to a lack of analysis of incidents and accidents, the opportunity to learn lessons and improve care were missed.

There was a lack of opportunities and procedures for staff and people to shape the direction of the service.

Quality monitoring and management oversight of the service was poor and audits in place were ineffective at identifying issues or promoting clear improvements.

We recommend that the service followed the complaints policy and responded formally to written complaints. We recommended that the service submit statutory notifications to CQC following serious incidents or safeguarding events where potential abuse is a concern.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for this service was good (last report published 12 September 2017)

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report. The provider has begun to take action to mitigate the risks we found.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Leda Homecare on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of 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 monitor the service/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; management of safeguarding issues; safe care; staffing; consent and governance of the service at 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. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.