Legend Integrated Care

Updated 8 December 2021

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was completed by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We looked at the information we already hold about the service. We also checked with the local authority if they had any experiences with this service. We used all of this information to plan our inspection.

During the inspection

We spoke with two people and two relatives about their experiences of the service. We also spoke with three members of staff and the registered manager. We reviewed a range of records. This included two people’s risk assessments, care plans, reviews, daily notes and medicine charts. We looked at two staff files in relation to recruitment and staff training. A variety of records relating to the management of the service including audits and policies were also assessed.

After the inspection

We continued to seek clarification about people’s care needs and to validate the evidence found.

Updated 8 December 2021

About the service

Legend integrated care is a domiciliary care service which supports people in their own flats and houses. They currently provide a live-in care service in two people’s own homes.

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

We found there were some shortfalls with how the management team audited and assessed the quality of the service. Risk assessments and care records were not always complete. Effective plans had not always been made to respond to the risks some people could face.

The management team were not supporting people to make end of life plans or having conversations about this. They were also not completing mental capacity assessments for people. People were not supported to have maximum choice and control of their lives and staff did not always 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.

Staff did not always support people to maintain their social life and follow their interests. The registered manager did not effectively check staff competency when they supported people to follow their interests. They were not reviewing the quality of this aspect of people's care. People’s care plans lacked detail to guide staff on how to support people’s physical needs.

People and their relatives spoke well of the service provided. They told us they felt safe and believed the staff were kind and caring.

People had regular staff who met their care needs. Staff knew how to keep people safe from harm.

Staff spoke of how they enjoyed working for Legend Integrated Care. Staff felt well supported by the management in terms of their availability when something goes wrong, with regular supervisions, meetings and training.

There was a positive culture in the management and staff team. They were passionate about managing the work and providing care visits which meant staff could fully meet people’s care needs in a sensitive and thoughtful way.

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

Rating

This service was registered with us on 12 December 2019 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date the service was first registered.

Enforcement

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. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified a breach in relation to the governance of the service and how the provider and registered manager monitored the quality of the service, at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.