LlyonHealth

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Audits and checks had been introduced and an action plan written to address any issues found. Staff now enjoyed working at the service and felt well supported in their role by the management team. They said they were able to speak with the management team if they had any issues or concerns. Changes in the management of the service were being introduced, with team leaders being trained to support the care workers, complete spot checks and oversee the rota. However, one local authority had concerns around the invoicing system not always being accurate and the time taken for the service to respond to requests for information. The registered manager was aware of these concerns and said they were working to improve the invoicing at the service. We saw the CQC had not been notified of 1 accident that had been reported by the staff team. We discussed what needed to be notified to the CQC with the registered manager. A suitable notification was made during the assessment.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff said they enjoyed working at the service and they felt well supported by the office staff. Staff told us how they prompted and encouraged people to be involved in their own care and support where possible to maintain their independence.

There had been recent changes in the management team. The service manager had left, with the registered manager saying they would be taking on the role of the service manager, supported by the care coordinator. Team leaders were also going to be introduced to provide further support for the staff team. Staff surveys were positive. Supervision and staff meetings were regularly held. Partner agencies had raised concerns around the invoicing and review systems, with some invoices being raised for calls that had not been completed and the service not using the local authority systems to agree changes in people’s support hours before the changes were made.

Staff said they felt well supported by the office staff. They said they were approachable, and they were able to raise any issues or concerns they may have.

The service was in the process of changing the management team. The service manager had left, and new team leaders were being introduced. This process had not been completed and we will review the impacts of this decision when we next assess this quality statement at the service. There were no issues raised with the care provided, however, procedures were not being followed to inform the local authority of any increase in people’s support hours, despite support being provided by the commissioning team. Information requested by the local authority was not provided in a timely way.

Staff said they were able to raise any concerns they had directly with the office, during supervision meetings or at staff meetings.

Records showed regular staff and supervision meetings were held. A staff survey had also been completed to gain feedback for the staff team about working at Llyon Health. The responses were seen to be positive.

Staff said they completed an induction when they started working for the service. The registered manager said they now provided additional support for new staff recruited from overseas to assist them to settle in to the country as well as their role.

Llyon Health recruited a diverse workforce. Records showed staff completed training in equality and diversity.

Staff said the management team were supportive and communication was good. Regular spot checks, supervisions and staff meetings were held. The registered manager acknowledged that their invoicing system needed improvement to ensure people were accurately charged for the care and support they received.

The care planner system alerted the office staff or on call manager if staff were late to a call or had not administered medicines as planned. They would follow these alerts up with a phone call to the staff member to ensure all support was completed as planned. Audits and checks were in place. Most of these had been completed by the service manager, who had recently left the service. The registered manager, care coordinator and new team leaders were due to complete the audits, spot checks, supervisions and audits going forward. We noted 1 incident that had not been reported to the CQC as required. We discussed the regulatory requirements for notifying incidents. The registered manager made the notification during our inspection. Our assessment of process indicated further work was needed to ensure the systems for oversight of all aspects of the service were fully embedded, and there was a full understanding of regulatory responsibilities.

People and relatives said they were able to contact the office to raise any concerns they had, and these were resolved. One relative said, “I have the [care coordinator’s] number and can get in touch with them whenever I need to. They have always resolved any issues I’ve raised.”

The registered manager acknowledged that their invoicing system and how they changed peoples support hours if their needs changed needed improvement to ensure they worked well with one local authority. One local authority said they often had to wait a long time to receive information requested. They were also investigating concerns about the service’s invoicing system and how they did not always follow the local authority’s procedures before changing their support hours when people’s care needs changed. We were told the invoicing system had been changed and should avoid further issues.

The local authority has set procedures to follow to authorise any increase in support hours provided. These were not always being followed. The invoicing system did not always take into account when calls had been cancelled, meaning people were charged for support they had not received. This had recently been changed to resolve this issue.

Staff spoke positively about working for the service. Issues raised by staff at the last inspection had been resolved. Staff surveys, staff meetings and supervisions were taking place, giving staff the opportunity to raise any concerns they had. Staff said they felt able to speak with the management team if they needed anything or people’s needs had changed.

Following our last inspection an action plan had been put in place and improvements had been made in staff recruitment, staff training and support. However, improvements to the way the service reported changes in the support hours people required had not been made.