Archived: Lyfem Home Care Services Uk Ltd

Lyfem Home Care Services Ltd is a domiciliary care service which provides personal care to people living in their own homes. 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. At the time of the inspection there were four people receiving care and support for personal care.

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

We found ongoing issues with the management of safety. Risks were not always assessed, and care plans lacked essential detail on how risks should be mitigated. People’s medicines were not always managed safely. Medicines support in care plans was not in line with current best practice guidelines. Care plans contained inaccurate information about the level of support people needed to take their medicines. The provider did not always follow safe recruitment processes.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The provider did not ensure consent to care was gained appropriately from the relevant person.

The provider had made some improvements since the last inspection. There were spot checks and supervision of staff. Despite improvements the quality assurance systems were not sufficiently robust and had not identified the ongoing issues we found with risk management and recruitment. Care records and medicine records were not checked by a senior member of staff to identify issues. The provider was not complying with the conditions of the registration as they had not informed us they had moved office.

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 (report published 7 January 2022)

and there were breaches of regulation. Although we found some improvements at this inspection the provider remained in breach of several regulations.

Why we inspected

We undertook this inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met and whether the provider had made the improvements set out in their action plan. At this inspection we found the provider had not made sufficient improvement and the overall rating for the service remains requires improvement.

This focused report covers the entirety of the key questions Safe and Well-Led and part of the key question Effective. Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection.

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 have identified ongoing breaches in relation to safe care and treatment, the recruitment of staff, consent to care and good governance. We have sent a Regulation 17(3) letter to the provider in relation to

their failure to effectively operate systems and processes to assess, monitor and improve the quality and

safety of the services provided. A Regulation 17(3) Letter stipulates the improvements needed to meet breaches of regulation, seeks an action plan and requires a provider to regularly report to CQC on their progress with meeting their action plan.

Follow up

We will meet with the provider to discuss how they will implement their action plan and make the required

changes to ensure they improve their rating to at least good. We will work alongside the provider and the

local authority to monitor progress. We will continue to monitor information we receive about the service,

which will help inform when we next inspect.

Lyfem Home Care Services is a domiciliary care service which provides personal care to people living in their own homes. 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. At the time of the inspection there were four people receiving care and support for personal care.

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

Risks to people were not consistently managed. People’s medicines were not always managed safely as medicine records lacked essential information to ensure staff understood how to administer medicines safely as prescribed. Staff were not taking part in the government’s COVID-19 testing programme for homecare workers. The provider did not always follow safe recruitment processes.

People’s health needs were not always assessed, and care plans also lacked information about people’s changing health needs. The provider did not ensure consent to care was gained appropriately. Staff did not always receive enough support and training to fulfil their role. We have made a recommendation about reviewing the support and training for staff.

The service was not always well managed. There was a lack of formal audits and quality assurance checks to identify issues with the safety and quality of the service. There had been no formal observations of staff carrying out their roles. The provider had not gathered formal feedback from people who used the service or staff.

People told us the staff were kind and caring. People were involved in everyday choices. People's privacy, dignity and independence was maintained.

People told us they received care that met their needs and preferences. Care plans contained details about people’s likes and dislikes about many aspects of people’s day-to-day lives. However, people’s end of life wishes were not considered. We have made a recommendation about incorporating end of life wishes into people’s care plans.

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 16/07/2020 and this is the first inspection.

Why we inspected

This was a planned inspection to provide a rating.

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 have identified breaches in relation to safe care and treatment, the recruitment of staff, consent to care and good governance. Please see the action we have asked the provider to take at the end of this report.

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 continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.