LJM - Homecare Lincoln

Updated 8 February 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

This inspection was carried out by one inspector and an Expert 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 homes.

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 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.

What we did before 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 used all of this information to plan our inspection.

During the inspection

We spoke with nine people who used the service and one relative about their experience of the care provided. We spoke with nine members of staff including the registered manager, manager, assistant manager, senior care workers and care workers.

We reviewed a range of records. This included four people’s care records and multiple medication 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.

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 spoke with two professionals who knew the service.

Updated 8 February 2020

About the service

LJM – Homecare Lincoln is a domiciliary care agency based in the Lincoln area providing personal care to 54 people who live in their own homes 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

There was a new manager who was in the process of applying to replace the current registered manager, who was in the process of moving in to a more senior role with the provider. The registered manager was honest and open with us about recent issues which had caused disruption and affected the governance of the service. The registered manager and manager had developed an action plan and were working to address issues. Staff were complimentary about the support they received from their managers and described a positive working relationship within the team.

Some people told us there had been a noticeable decline of communication and rostering in previous months which had resulted in inconvenience and disruption. The registered manager was aware of the issues and had clear plans to address this. Other people told us their care had not been affected and they were satisfied with the standard of their care and communication with the service.

Managers and staff were clear about their roles. Team meetings took place regularly and the provider actively sought to obtain feedback from the staff team and people using the service. The manager and staff team built good working partnerships with health and social care professionals and were developing and building links in the community.

The service provided sufficient numbers of staff to meet people's needs. People told us the service they received was generally reliable. Some people told us staff were sometimes late and expressed frustration with disruptions. Other people told us there were occasions where staff were late due to traffic but were always contacted and kept up to date. Staff were recruited safely and in line with regulations.

People told us they felt safe and were protected from abuse. Staff received training to ensure they could recognise the signs of abuse and report them confidently. Risks associated with people’s care were managed. Records showed people had risk assessments and these were reviewed regularly. People told us staff supported them safely. People told us they were supported to take their medicines safely. Staff received training to enable them to administer medicines and processes were in place to ensure staff were competent. Accidents and incidents were recorded and reported. Systems to review accidents and incidents were being developed to improve the way lessons were learnt.

Records showed people’s needs were assessed prior to using the service. People confirmed this.

Staff told us they received the training they needed to do their job well. Records confirmed staff were provided with induction and ongoing training. People were supported to access the healthcare they needed. The service worked with people and their relatives to make necessary referrals to healthcare services. People’s consent to care was sought. 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.

People and relatives told us staff were caring and kind. Staff told us they were happy in their roles and enjoyed spending time talking to people and getting to know them. Most people told us they were given the opportunity to express their views regularly and were involved in their care. Some people told us they had not recently been asked for feedback about their care. Records showed surveys and telephone checks were carried out to see if people were satisfied. Staff were knowledgeable about how to maintain privacy and dignity. People told us staff behaved with professionalism and were respectful of their homes when providing care.

Some people told us inconsistent call times and late calls had resulted in them receiving care which was not responsive to their needs. Other people told us they were totally satisfied with their care and the provider had been accommodating and flexible to ensure their care was responsive.

Care planning reflected people’s basic needs, but some development was required to ensure care planning was tailored to meet people’s needs in a more personalised way. The manager showed us examples of a new care plan format which would improve the quality of information recorded.

Records showed people's care was reviewed regularly. Care was delivered by staff who understood the needs of the people they were supporting. People knew how to complain and raise concerns.

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

Rating at last inspection

The last rating for this service was requires improvement (published 29 October 2018).

Why we inspected

This was a planned inspection based on the previous rating.

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.