Background to this inspection
Updated
10 December 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
This inspection was carried out by two inspectors, a specialist advisor who was a learning disability nurse and two Experts 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 provides personal care to people living in their own houses and flats. This service also provides care and support to people living in four 'supported living' settings, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.
The service did not have a manager registered with the Care Quality Commission. This means that the provider is 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 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or a member of the management team would be in the office to support the inspection.
Inspection activity started on 11 October 2021 and ended on 27 October 2021. We visited the office location on 12 October 2021 and 20 October 2021.
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 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 with seven people who used the service and nine relatives about their experience of the care provided. We spoke with 12 members of staff including the nominated individual, members of the training and management teams (including a newly appointed manager), senior support workers and support workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included 13 people’s care records and multiple medication records. We looked at seven 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.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We also spoke with a number of professionals who regularly visit or were involved with the service.
Updated
10 December 2021
About the service
Lastminute Care and Nursing is a domiciliary agency providing care to 134 people at the time of the inspection. People receiving a service required varying levels of support. Support packages ranged from short term domiciliary care to 24-hour support for people with ongoing mental health needs, autistic people and people with a learning disability.
A number of people requiring 24-hour support lived in 'supported living' services. People held an individual tenancy for their bedroom and shared communal areas such as lounges and kitchens. Each 'supported living' service had designated space for staff to store their belongings, maintain records and provide sleeping in support.
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
We found sufficient improvements had been made to ensure the provision of safe care; the service was no longer in breach of regulations. A high turnover of staff and management within the ‘supported living’ services had continued to be a factor since our last inspection. Although we saw this had improved, some people receiving support, relatives and professionals expressed concern about the impact this had on the ability for the provider to deliver consistent care. We sought assurances and the provider evidenced plans to address this.
We have also made a recommendation about maintaining induction records for new staff.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• Model of care and setting maximises people’s choice, control and independence
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives
Since the last inspection the provider had reviewed its policies and procedures in line with these principles; the support needs of people had been appropriately assessed and planned. People were treated with dignity and respect and staff working for the service were committed to providing person centred care. People spoke positively of the care they received.
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 (and update)
The last rating for this service was requires improvement (published 08 April 2021) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.