Archived: Litch Care Services Limited Liverpool

Updated 23 March 2024

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post who was also a director of the company and the CQC nominated individual.

The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Notice of inspection

We gave the service a short period of 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 reviewed information we had received about the service. We sought feedback from the local authority. We used all this information to plan our inspection.

During the inspection

We spoke with one family member. We spoke with three members of staff including the registered manager. We reviewed a range of records. This included two peoples care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including governance records and policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 23 March 2024

About the service

Litch Care Services Limited Liverpool is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection there were 2 people being supported by the service. Not everyone who uses the service receives 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.

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

People were exposed to avoidable risk of harm as systems to ensure the safe and proper management of medicines were inadequate. Records for the administration of medication were not always completed and we were not assured all relevant information was included on medication administration records (MAR) to enable staff to safely administer medicines.

Service users were at risk of receiving unsafe care and treatment as care plans and risk assessments were not adequate or up to date. Medical and health needs were not properly described, or risk assessed; information about service user needs and care was contradictory placing people at risk of inappropriate or unsafe care.

Assessments of people's individual needs had not been consistently recorded and did not consider best outcomes for people. Care plans were not person centred and did not hold sufficient information to guide staff when supporting people. The provider had not fully explored how to present information in an accessible way to meet individual needs.

Robust recruitment practices were not followed. Systems to support and develop staff did not ensure they had the knowledge and skills needed to support people safely and effectively. Conflicting information was provided by management for permanent staff employed at the service and records demonstrated inaccuracies.

Feedback from a family member was positive about the support provided and felt the

registered manager was responsive. We were told staff enabled people to make their own decisions and offered choice when carrying out tasks. Management, however, did not demonstrate a clear understanding of the Mental Capacity Act 2005 and the service was not working within the principles of the Mental Capacity Act. (MCA). Records did not clearly evidence capacity had been assessed and decisions were made in the people's best interests.

Governance systems were ineffective. The provider had failed to implement systems to assess, monitor and improve the service. Audits and checks completed by the registered manager had not identified the issues we found during this inspection. The registered manager failed to demonstrate knowledge and understanding of their role, quality performance, risk and regulatory requirement.

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 Inadequate (published 12 October 2022). At this inspection we found the provider remained in breach of regulations regarding the management of medicines, risk management and the governance of the service.

Why we inspected

We carried out an announced inspection on 16 and 20 November 2023 following on from breaches that were found at the previous inspection in October 2022. The provider completed an action plan after the last inspection to show what they would do and by when to make improvements.

We undertook this focused inspection to check improvements had been made and if the provider 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. For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has remained as inadequate. This is based on the findings at this inspection.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, fit and proper persons employed and governance at this inspection.

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

Special Measures

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this time frame and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.