LlyonHealth

LlyonHealth provides personal care to people living in their own homes. Not everyone supported by 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 the service was providing personal care to 14 people.

People’s experience of using this service and what we found

Staff continued to not be recruited safely, with gaps in employment histories and references not always being completed. This meant people were potentially at risk of staff being employed to work with them who were not suitable.

Improvements had been made to call times and we received no reports of missed calls. However, we received mixed feedback from people and their relatives that call times were not always exact. However, we found the majority of the calls deemed late, were within the thresholds set by the local authority.

At this inspection staff morale was considerably low, with many staff speaking out to raise issues around their holiday pay entitlement and travel time pay. We have also shared their feedback with the local commissioning team.

Staff told us they received regular training, but for many staff the majority of their training had been completed at other care companies they had worked for prior to joining LlyonHealth. We were not assured the registered manager has assessed these new staff members competency levels, there was an overreliance these staff members had the sufficient skills to provide safe care and treatment.

The provider had implemented a new governance framework at the service. However, these systems and processes to ensure oversight of the safety and quality of the service were not always effective. Audits completed had not always identified the concerns we found on inspection. At this inspection there was an overreliance on office staff to complete a number of quality checks.

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.

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 24 October 2022).

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements.

This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for LlyonHealth on our website at www.cqc.org.uk.

Enforcement and recommendation

We have identified breaches in relation to staffing, safeguarding, training and governance at this inspection.

We have made a recommendation about the escalation of safeguarding concerns.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

LlyonHealth provides personal care to people living in their own homes. Not everyone supported by 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 the service was providing personal care to 16 people.

People’s experience of using this service and what we found

Quality assurance systems were not always effective or in place. Medicines systems and processes required further improvements to ensure people received their medicines as prescribed. The implementation of new systems and processes was planned, however there was no timescales on when this would be implemented.

Staff were not recruited safely. This meant people were potentially at risk of staff being employed to work with them who were not suitable.

There were enough staff members available to support people. However, the service needed to improve their systems to ensure staff arrived on time for visits. People and their relatives raised concerns around call timings.

The registered manager was not able to robustly demonstrate the training provided to care workers was fit for purpose. We found staff completed a high number of e-learning courses in one day, which would impact the staff members ability to retain this level of information.

The accidents and incidents tracker could not be accessed when we visited the service due to a computer glitch. We were not assured with the oversight of accidents and incidents at the service.

We have made a recommendation about the management of accidents and incidents.

People were protected from abuse because systems were in place to keep people safe. Staff were aware of their responsibilities to keep people safe

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's needs were assessed before the service began to provide care and support. People’s views were sought and this ensured their preferences informed their care plan. People were supported to access appropriate healthcare.

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 5 July 2019).

Why we inspected

The inspection was prompted in part due to concerns received about the recruitment of staff. A decision was made for us to inspect and examine those risks.

As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to unsafe recruitment, how medicines were managed, shortfalls in relation to staff schedules and training and ineffective auditing systems.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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

This service is a domiciliary care agency that provides support to people in their own homes. It provides a service to younger and older adults, people with physical disabilities, sensory impairments, learning disabilities or dementia. The provider has one domiciliary care agency within their registration. The service's office is based in Manchester, and support is provided to people in surrounding areas. At the time of the inspection it was providing a service to 10 people, who were all receiving personal care.

People’s experience of using this service and what we found

People’s outcomes were consistently good, and people’s feedback confirmed this. One person told us, “I am very happy with the care and I would recommend the company, they are very good.” A relative commented, “The service has been brilliant and so supportive. The carers are a God send. I don’t know what we have done to deserve them.”

Staff worked with other agencies to provide consistent, effective, timely care. One relative told us, “The carers are always on time, but if they are running a little late, they will ring and let us know.”

People told us staff were kind, courteous and sensitive. One person said, “The carers are good. I speak to them and we do have a laugh”. Relatives also spoke positively about the staff. One relative commented, “The carers are very engaging and so caring.”

The service was well led. The registered manager promoted best practice in person centred care. There was a clear culture based on achieving positive outcomes for people.

Staff spoke positively about how the service was managed and one staff member told us, “I enjoy working here. There is a good team spirit and we work well together. I would recommend this service to a family member if they needed domiciliary care.”

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 told us they felt safe. Staff had a good understanding of how to safeguard people from abuse.

The service met the characteristics of Good in all areas.

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

Rating at last inspection

This service was registered with us on 15 June 2018 and this is the first inspection.

Why we inspected

This was a planned inspection of the service since it was newly registered in June 2018.

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.