Background to this inspection
Updated
5 June 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, 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 over two days.
Service and service type:
LANH is a domiciliary care agency registered to provide personal care for people who require support in their own home. People receiving care and support had a range of needs including, the elderly and people living with dementia.
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:
This was a comprehensive inspection, which took place on 30 April and 02 May 2019 and was announced. The provider was given 72 hours' notice of the inspection as we needed to be sure that the office was open, staff would be available to speak with us and people being enabled would be able to speak with us.
What we did:
We reviewed information we had received about the service since the last inspection on 24 April 2018. This included details about incidents the provider must notify us about, such as abuse or when a person dies. The provider completed a Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information including the information in our last inspection report to plan our inspection. We took this into account when we inspected the service and made the judgements in this report.
During the inspection, we spoke with one person using the service, a relative, two care staff, the registered manager and the nominated individual. We requested feedback from a range of healthcare professionals involved in the service. We received feedback from a local authority commissioner.
We reviewed a range of records. This included three people's care records and medicines records. We also looked at two staff files including their recruitment, supervision and training records. We reviewed records relating to the management of the service and a variety of policies and procedures implemented by the provider. We also looked at other records the provider kept, such as meetings with people and surveys they completed to share their views.
We asked the registered manager to send additional information after the inspection visit. This included the staffing rota, staff training plan and care related guidance documents. The information we requested was sent to us in a timely manner.
Updated
5 June 2019
About the service:
LANH is a domiciliary care agency registered to provide personal care for people who require support in their own home.
Not everyone using LANH receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection, they were supporting nine people who received support with personal care tasks.
People’s experience of using this service:
The service had improved since we last inspected it on 24 April 2018. People and relatives, we spoke with was positive in their feedback. A relative said; “The service we receive has been fantastic.”
Care plans contained risk assessments, which were appropriately linked to people’s support needs.
Processes were in place to identify and reduce any environmental risks to people and care workers.
Staff had received infection control training, staff told us they had a good supply of personal protection equipment and showed they knew how important it is to protect people from cross infection.
The provider had suitable processes in place to safeguard people from different forms of abuse. Staff had been trained in safeguarding people and in the service’s whistleblowing policy. They were confident that they could raise any matters of concern with the registered manager, or the local authority safeguarding team.
The service was working according to the Accessible Information Standard (AIS) and its requirements during our inspection. This meant that people were able to communicate effectively with care workers or understand what was going on and involved in decision-making.
People’s needs were assessed prior to receiving a service including the protected characteristics under the Equalities Act.
Staff were skilled in carrying out their role. Trained staff were employed to meet people’s needs. Staff said they were supported by the registered manager.
People were encouraged to raise any concerns they had or make suggestions to improve the service they received.
Staff felt there was an open culture where they were kept informed about any changes to their role. Staff told us the registered manager was approachable and listened to their ideas and suggestions.
The service had effective systems in place to assess, monitor and improve the quality and safety of the services provided.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
Requires Improvement (Report published 17 May 2018).
Why we inspected:
At our last inspection on 24 April 2018, we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breach was in relation to our findings, that the provider had failed to operate effective quality monitoring systems. We also recommended that the provider sought guidance on the implementation of comprehensive risk assessments and that the provider sought advice and guidance about making themselves available to people who use the service at all times particularly during emergencies to mitigate risk to people who use the service. We asked the registered provider to take action to meet the regulations. However, due to technical problems, we did not receive sent action plan by the date we stated. At this inspection, we found that improvements had been made in relation to the requirement made above.
Follow up:
We will continue to monitor the service through the information we receive. We will carry out another scheduled inspection to make sure the service continues to maintain a Good rating.