Lotus Home Care, Rotherham

Lotus Home Care Rotherham is a domiciliary care service providing personal care support to people living within their own homes. The service was providing care and support to 93 people at the time of the inspection. These included older people and younger adults, people living with dementia, people with a physical disability, and people with a learning disability and autistic people.

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 expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

There had been times when the care delivered did not meet people's expectations. This had been related to staffing shortages. People told us their care calls were too late or too early and the continuity of care staff had deteriorated. Some people did not feel comfortable when their preference for being attended by care staff of a particular gender was not met. The provider was working to manage people’s care and reduce any risk. The provider had successfully recruited new staff, call times were stabilising and there was better staff consistency.

We have made a recommendation about the provider’s business continuity planning in relation to staffing.

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.

Right Care

People’s care plans were up to date and detailed the care and support people wanted and needed, so care was person-centred. Risks to people's health and safety were identified and assessed to ensure safe care delivery for people. Overall, people’s medicines were managed safely.

Right Culture

There was a culture of continuous improvement and the provider had strengthened their systems for monitoring the quality and safety of the service. The provider asked people and staff for their feedback about the service and this was used to learn lessons and make improvements. The provider had further developed and improved their systems and processes to make sure people were consulted and kept informed.

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 good (published 4 August 2018).

Why we inspected

We received concerns in relation to the quality and safety of care provided, missed and late visits, the management and oversight of the service and medicine management. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

There was a registered manager in post at the time of our visit. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Feedback that we received from people and their representatives about staff and the service was very positive. People who used the service felt they were treated with kindness and said their privacy and dignity was respected. Staff had a good understanding of legislation designed to protect people's rights and were clear that people had the right to make their own choices.

Staff were involved and committed to achieving the service's values and vision. The service had systems to monitor and review the quality of the care provided. Most people told us they had continuity of care workers. They said staff always arrived on time and stayed for their allocated time. They told us staff always completed the tasks required of them along with any additional requests. People were supported by staff who demonstrated kindness and compassion.

Staff knew people well. They understood people's physical, social and emotional needs. Staff had a good understanding of the procedures to follow to safeguard people from the risk of abuse. Staff recruitment was thorough and there were enough staff employed with the right skills to meet people's needs.

Risk assessments were carried out in relation to people's homes and to their individual needs and actions were taken to mitigate any risks identified. Medicines were handled safely by staff who had been trained to do so.

Spot checks were carried out to monitor staff performance. Staff attended regular training to ensure they could meet people's needs. There was a thorough induction to the service and staff felt confident to meet people's needs before they worked independently. Staff felt supported by the managers and providers and could visit the office to discuss any matter that they wished. Staff told us they felt supported, listened to and valued.

The registered manager and providers had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS are regulations that have to be followed to ensure people who cannot make decisions for themselves are protected. They also ensured people were not having their freedom restricted or deprived unnecessarily.

Care plans provided comprehensive information about how people wished to receive care and support. These were reviewed and updated and reflected a person-centred approach to care. People were asked for their view on the service and support they received and were aware how to make a complaint. There was an open and positive culture at the service where people, relatives and staff felt listened to.