We carried out a review of the data available to us about Liznett Care Services Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Liznett Care Services Limited, you can give feedback on this service.
Bexley (Liznett Care Services Ltd) is a domiciliary care agency that provides personal care to people 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. They were providing personal care to 34 people at the time of the inspection.
People’s experience of using this service and what we found
There were safeguarding adults’ procedures in place and the registered manager and staff had a clear understanding of these procedures. Risks to people were assessed and staff were aware of the action to take to minimise risks where they were identified. People received support from staff to take their medicines safely. Robust recruitment checks were carried out before staff started work and there were enough staff to meet people’s care needs. The provider and staff were following government guidance in relation to infection prevention and control. Staff had received training on COVID 19 and the use of personal protective equipment (PPE).
Staff received training and support relevant to people’s needs. People’s care needs were assessed before they started using the service and care plans were in place to ensure staff could support them safely. Where required people received support from staff to maintain a balanced diet. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.
People using the service told us they were treated in a caring and respectful manner and they were consulted about their care needs. They knew how to make a complaint if they were unhappy with the service. People had access to end of life care and support if it was required.
There were effective systems in place to monitor the quality of service that people received. Staff said they received good support from the registered manager, care coordinator and office administrator. The registered manager took people and their relatives views into account through satisfaction surveys and any feedback they received was used to improve the service. The registered manager and staff worked with health care providers to plan and deliver an effective service. The service had a business continuity plan in place that made provisions for safe care in the event of an emergency.
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 (published 14 August 2019) and there were breaches of our regulations.
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection to assess if the provider was complying with our regulations.
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.
Bexley (Liznett Care Services Ltd) is a domiciliary care agency that provides personal care to older people 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. They were providing personal care to 40 people at the time of the inspection.
People’s experience of using this service and what we found
At our last inspection in 2018 we found there had been breaches to regulations on safe care and treatment and good governance. At this inspection we found though improvement had been made, further improvement was required; specifically, medicines management was not always safe, risk assessments did not always address people’s medical conditions and quality assurance systems were not effective in monitoring or improving care.
Records of incidents and accidents were inconsistent. Staff were not always on time. Food and fluid preferences were not always recorded correctly. People and relative’s involvement in care plan reviews was not always recorded. There were mixed views on promotion of people’s independence. Care plans were not always up to date.
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. We have made a recommendation on recording capacity and consent.
People were supported with their health care needs, though we have made a recommendation about ensuring staff have access to the most up to date information about people’s health.
There were safeguarding systems and processes in place. Recruitment was carried out with people's safety in mind. Staff used infection control practices.
People’s needs were assessed before they used the service. Staff were supported through induction, training, supervision and appraisal. The service worked with other agencies to ensure people received good care.
People told us staff were caring. Policies and procedures at the service supported equality and human rights. People expressed their views and had input into their care. People's privacy and dignity were respected.
People knew how to make complaints and the service responded appropriately when complaints were made. The service was able to work with people who were at the end of their life.
People thought highly of the management. The management acted responsively to concerns. People and staff were able to feedback about the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The previous rating for this service was requires improvement (published 15 August 2018). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made/ sustained and the provider was still in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified continued breaches in relation to safe care and treatment and good governance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.
This inspection took place on 18 and 20 June 2018 and was announced. Bexley is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults. At the time of this inspection 40 people were using the service.
There was a registered manager in post. 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.
At our comprehensive inspection on 20 April 2017, we found breaches of legal requirements as risks to people had not always been assessed, identified and did not have appropriate management plans in place. People did not always have care plans in place to ensure the service was meeting all their needs. People’s nutritional needs and preferences were not always documented. Staff recruitment records did not always contain fully completed application forms, references or up to date criminal records checks. We asked the provider to take action and they sent us an action plan which they would complete by 25 August 2017.
At this inspection, we found that the provider had made some improvements however, we found further breaches of legal requirements in relation to safe care and treatment and good governance. We found that people’s medicines were not always managed safely, the systems in place to monitor and assess the quality of the service were not always effective and records were not always accurate, complete, and presented promptly when required.
The provider had a recruitment procedure in place and had updated their application form to include previous employment history. People were protected from available harm because risk had been identified, assessed and had management plans in place. However, information was not always consistent and easy to locate in their care files.
People were protected from the risk of abuse because the provider had systems such as policies and procedures in place and staff had been trained to ensure they knew their responsibility to safeguard people they supported. Staff knew of the provider’s whistleblowing procedure and told us they would use it if they needed to. People were protected from the risk of infection because staff followed the provider’s infection control protocols. Adequate numbers of staff were deployed for each visit to ensure people received safe care and support. Accidents and incidents were reported and recorded and learning was disseminated to drive service improvement.
Before people used the service, their needs were assessed to ensure they would be met by the provider. People were supported to eat and drink sufficient amounts for their health and well-being. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff were supported with induction, training, supervision and appraisals to ensure they had the knowledge and skills to deliver a safe and efficient service. People were supported to access health care services where needed to maintain good health and well-being. The provider worked in partnership with health and social care professionals to provide joined-up care.
People were treated with kindness and compassion. People and their relatives were involved in making decisions regarding the care they or their loved ones received. People’s privacy and dignity was respected and their independence promoted. People were provided information about the service to ensure they knew the level of support to expect.
People received support from staff that met their needs and each person had a care plan in place with appropriate guidance to ensure their needs were met. People were supported to engage in activities that stimulated them. Staff understood the importance of the Equality Act and supported people in a caring way. The provider had a complaints policy in place and people knew how to complain if they were unhappy with the service. Where people had made any complaints, or raised concerns this was addressed to ensure they were satisfied with the outcome.
There were systems in place to support continuous learning and improve the quality of the service. People’s views were sought regularly though telephone monitoring, home visits and annual surveys and their feedback was used to improve the service. The provider worked in partnership with key organisations such as the local authority and other healthcare professionals to plan and deliver an effective care and support.
The registered manager understood their responsibility to notify CQC of important events that happen at the service. The provider had values and visions and the staff team adhered to these when they performed their roles. All staff we spoke with told us they were happy working at the service because they felt supported and respected. The provider had displayed their CQC rating at their office.
This is the second time this service has been rated Requires Improvement. You can see what action we told the provider to take at the back of the full version of the report.
Bexley is a domiciliary care agency that provides personal care for people living in their own homes. At the time of this inspection 10 people were using the service.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
During our inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because risks to people had not always been assessed or staff were not aware of how to manage identified risks safely. People did not always have care plans in place to ensure the service was meeting all of their needs. People’s nutritional needs and preferences were not always documented. Staff recruitment records did not always contain fully completed application forms, references or up to date criminal records checks. You can see the action we have asked the provider to take in respect of these breaches at the back of the full version of the report.
There were safeguarding adult's procedures in place which were robust and staff understood how to safeguard the people they supported. There was a whistle-blowing procedure available and staff said they would use it if they needed to. The service had systems in place to manage accidents and incidents whilst trying to reduce reoccurrence.
Medicine records showed that people were receiving their medicines as prescribed by health care professionals. There were enough staff on duty to meet people's needs and there was an out of hours on call system to offer support to staff if needed.
Records confirmed staff training was up to date. Staff received supervision and training appropriate to meet people’s needs and to enable them to carry out their roles effectively. There were processes in place to ensure staff new to the service were inducted into the service appropriately.
People’s consent was sought before care was provided. The registered manager and staff understood the Mental Capacity Act 2005 (MCA) and acted according to this legislation. At the time of inspection the registered manager told us people they supported had the capacity to make decisions for themselves. People had support to access health care appointments if needed.
People were treated with kindness and compassion and people's privacy and dignity was respected. People were provided with information about the service when they joined in the form of a 'service user guide' which included the service's complaints policy.
People and their relatives were involved in their care planning and staff respected their wishes and met their needs. Care plans were reviewed on a regular basis. Peoples' care files were kept both in people's home and in the office. People were supported to be independent where possible such as attending to some aspects of their own personal care.
People and their relatives knew about the home's complaints procedure and said they believed their complaints would be investigated and action taken if necessary.
People told us they thought the service was generally well run and that the registered manager was supportive. There were systems in place to carry out staff spot checks to ensure consistency and quality was maintained whilst supporting people in the community. The registered manager was aware of their responsibilities as a registered manager in relation to notifying CQC about reportable incidents.
There were some processes in place to monitor the quality of the service provided, however these have not been operational for a sufficient amount of time for us to be sure of consistent and sustained good practice.