Background to this inspection
Updated
9 January 2024
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 Health and Social Care Act 2008.
Inspection team
The inspection team consisted of 1 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 houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
The inspection was announced. 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 the inspection
We reviewed information we had received about the service since the last inspection, including notifications of significant events. We contacted the local authority to ask for feedback. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager and the nominated individual. 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 5 people's care records and 3 staff records. A variety of records relating to the management of the service, including audits were also reviewed. As part of the inspection, we spoke with the relatives of 9 people who used the service and 2 care workers. A further 4 care workers emailed us feedback of their experience of the service.
Updated
9 January 2024
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.
About the service
Lifestyle Care Services Limited t/a Home Instead Senior Care is a domiciliary care agency providing personal care and support to people living in their own homes. The service is registered to offer support to older and younger adults, adults with learning disabilities, and people with mental health needs.
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, 45 people were receiving support with personal care.
People’s experience of the service and what we found:
Overall, the service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture, but found a number of areas where improvements were required.
Right Support: In terms of consent to care, people were not always supported to have maximum choice and control of their lives and staff did not always 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. Staff focused on people's strengths and promoted what they could do. People were supported by staff to pursue their interests as part of their care plan. Staff communicated well with people. They also supported people with their medicines in a safe way.
Right Culture: The values of the organisation, management and staff helped people to feel included and empowered. People and those who were important to them were involved in planning their care. The managers evaluated and monitored the care and support people received and involved other relevant people such as relatives, in care planning. However, we found the systems used to monitor service delivery did not always record lessons learnt or consistently identify areas for improvement.
Right Care: Staff promoted equality and diversity in their support for people. They understood people's cultural needs and provided culturally appropriate care. Staff protected and respected people's privacy and dignity. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people's needs and keep them safe.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk.
Rating at last inspection
The last rating for this service was good (published 16 October 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Lifestyle Care Services Limited t/a Home Instead Senior Care on our website at www.cqc.org.uk.
During the inspection we found there was a concern with consent to care, so we widened the scope of the inspection to include the key question of effective.
Enforcement and Recommendations
We have identified a breach in relation to good governance. We also made recommendations regarding risk assessments and consent to care.
Please see the action we have told the provider to take at the end of this report.
Follow Up
We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.