Lincs

Updated 16 May 2019

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection was carried out by one inspector.

Service and service type: The service is a ‘domiciliary care agency’ providing care to people in their own homes. The service was currently supporting older people, some of whom were living with dementia or physical disabilities.

Lincolnshire supports people with personal care and social support in the Market Rasen, Binbrook and Great Limber areas of Lincolnshire. At the time of the inspection 30 people were receiving personal care.

The service has a manager registered with the Care Quality Commission (CQC). 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: The inspection took place on 22 March, 1 and 2 of April 2019 and was announced.

We gave the service 48 hours’ notice of the inspection visit because we needed to be sure the registered manager would be in. However, when we contacted the service we found the registered manager was unavailable for 4 days. We visited once they had returned to work and were able to assist us.

What we did: Before the inspection we checked information, we held about the service. This included notifications the provider had sent us about events or incidents that occurred and which affected their service or the people who used it. We contacted the local authority’s adult safeguarding, commissioning and quality monitoring team as well as Healthwatch England, (the national consumer champion for health and social care) to ask for their feedback about this service. We used this information to help plan our inspection.

During the inspection, we spoke with three people using the service and five relatives by phone. We asked about their experiences of the service. We spoke with the registered manager, director and three staff.

We reviewed a range of documentation including three people’s care records, medicine administration records (MARs), quality monitoring checks and audits, policies and procedures and three staff recruitment files, including training, supervision and appraisal records. We also looked at the compliments and complaints received.

Updated 16 May 2019

About the service: Lincolnshire is a domiciliary care agency. It is registered to provide personal care for older people.

People’s experience of using this service: The provider did not have specific policies to help guide staff for some specialised areas of care.

Audits and checks to monitor the service were still being developed. The auditing of bed rail safety checks was not in place.

We found one person had undertaken shopping and domestic work for people using the service in emergencies, without them having any employment checks undertaken. The registered manager informed this practice would cease immediately.

The provider monitored the length of calls provided for people. The provider’s 'Client Guide' did not inform people that they would be charged for their call if staff were allowed to leave early if there was nothing more they wanted them to do. This information was also not in the staff handbook.

People told us they were satisfied with the service they received. Safeguarding policies and procedures were in place to help to protect people from harm and abuse. Staff followed infection prevention and control practices. Staffing levels were monitored and there were enough skilled and experienced staff to meet people’s needs. Risks to people’s wellbeing and in their home environments were identified to help protect all parties.

Staff received induction, training, and ongoing support through supervision and spot checks of their practice which helped them to support people.

Records confirmed people’s input and where they were unable to consent the provider followed appropriate legislation and best practice guidance to make sure care was delivered in people’s best interests.

Staff understood the importance of providing person-centred care and they developed positive relationships with people and their relatives. People received support from staff who encouraged their independence to live fulfilled lives free from unnecessary restriction.

People told us staff were caring and kind. People confirmed they made decisions about their care and support. Information was provided to people in a format they could understand that complied with the Accessible Information Standard.

Where necessary, staff contacted healthcare professionals for advice and guidance to protect people’s wellbeing. People’s independence was promoted and encouraged and their dietary needs were met. End of life care was provided for people by the service. Concerns and complaints raised were dealt with appropriately.

The provider continued to develop audits and checks to monitor the quality of service provided. People using the service, their relatives and staff had the opportunity to provide feedback. Data security was maintained.

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

Rating at last inspection: This was the first inspection of this service.

Why we inspected: We inspected the service in response to concerns that the Commission had received relating to recruitment, infection control, length of calls and the care provided for some people.

Follow up: We will continue to monitor this service and inspect in line with our re-inspection schedule or sooner if we receive information of concern.