LlyonHealth

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People felt safe supported by Llyon Health staff. Risks were identified and regularly reviewed. Guidance was provided for staff to manage these risks. People received their medicines as prescribed. Staff were unable to log out of a call until identified medicines had been administered. Staff knew how to report any incidents, and these were reviewed by the management team. However, a local authority told us the service did not always follow their procedures where people’s support hours were increased. They said there were also incidences where invoices were raised for care calls that had not been fulfilled, resulting in people paying for calls they had not had. The registered manager acknowledged this during the assessment and said they were working to improve their invoicing system.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People said they felt comfortable and safe with Llyon Health staff.

Staff told us they knew how to report accidents and incidents. The care coordinator or registered manager reviewed the incidents. Care plans were updated if needed.

A spreadsheet was used to collate all incidents and accidents so these could be reviewed for any patterns. The registered manager said they reviewed any incident reports and made referrals to the local authority as needed. However, we found a recent incident had not been reported to the CQC as required. The registered manager made the notification to the CQC during the inspection.

Staff told us they had access to information about people’s needs through care plans.

One local authority said Llyon Health sometimes increased people’s support hours without following their procedures for this to be authorised.

An initial assessment of people’s needs was completed, and a care plan written. Clear routines for each care visit were in place. However, local authority systems were not always followed when people’s needs changed and the support hours were altered.

People and relatives spoke positively about the care and support they received. They felt confident that people were kept safe. They said they were able to contact the office if they had any concerns and these concerns were then resolved.

Staff felt confident about how to report abuse and that action would be taken. The registered manager said they reviewed any safeguarding reports and made referrals to the local authority as needed. Most people had capacity to agree to their support. People’s capacity was assessed by the local authority when commissioning the support.

Suitable processes were in place to safeguard people. However, statutory notifications were not being submitted to the CQC. The local authority had concerns that Llyon Health had submitted invoices for a few calls that had not been completed. Where people were paying for their own care, this meant they were paying for support they had not received. This was currently being investigated by the local authority. We were told the invoicing system had now been changed to resolve this issue going forward. The registered manager had raised this issue themselves with the inspector during the assessment.

People felt safe and they and their relatives told us they were involved in discussions about their needs.

Staff understood people’s needs and risks and said this information was available in the care files or through their mobile phone app.

Risks were assessed and guidance provided to manage these risks. Risks were reviewed and updated if people’s needs changed. An environmental risk assessment was completed for all properties staff visited.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People and relatives said the regular staff were good. They arrived on time and stayed for the full length of the calls. Some people said they had had a lot of different care staff over time, but the main carers knew their needs well. One person said, “They’re always helpful and try to do their best.” A relative said, “The ones’ who have been there a while know what they’re doing.”

Staff said they had travel time between calls, were able to get to calls on time and stay the full length of the call time. They said they had the training for their role and felt supported. They had regular supervision meetings, staff meetings and spot checks observations were made of their practice. Staff said there was an on-call system in place in case they needed support outside of office hours. The registered manager said they had a challenge to retain staff. Most staff were recruited from overseas and after receiving training often left the company. Additional induction training had been introduced to support new overseas staff to settle into the country, learn about the culture of the people they would be supporting and support staff with the nuances of spoken English.

Staff were safely recruited, with improvements having been made since the last inspection. All pre-employment checks had been completed prior to the member of staff starting work. A training matrix showed a high staff compliance. Staff were prompted when any training needed to be refreshed.

People did not comment on infection control.

Staff said there was a supply of PPE in each property, and they were able to collect any PPE they needed form the office.

PPE was available in the office for staff to collect when they needed it.

Where applicable, people said staff assisted them with their medicines safely.

Staff had received training in administering medicines and had been observed during this training.

People’s support needs in relation to medicines was clearly recorded, including where people self-medicated or were assisted by their family. Staff recorded electronically the medicines they had administered. They were not able to log out of a call until they had completed this recording or input a reason why the medicines were not administered. The electronic system sent an alert to the care coordinator and registered manager if medicines were late being administered. They would then contact the relevant member of staff to check the medicines were being given.