9 November 2023
During an inspection looking at part of the service
Lily health Care limited is a domiciliary care service providing personal care to people who live in their own homes. The service is registered to support people with a variety of needs including people who live with dementia, people with physical disabilities, older people, people with a learning disability and autistic people. At the time of the inspection the service was supporting 12 people. Some people were supported by care staff who lived in at people’s homes and provided 24 hour support to people in their own homes.
Not everyone who used 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.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
At the time of the inspection, the location did not care or support anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
Right Support:
Staff supported people with their medicines, however records needed improving to ensure they were accurate and completed in full without any gaps. Risks to people were not always assessed and those in place required more detail with actions for staff to follow. People were supported by a consistent staff team who knew them well and understood their needs.
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.
Right Care:
Staff protected and respected people's privacy and dignity. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff promoted equality and diversity. They understood people's cultural needs and provided culturally appropriate care.
Right Culture:
The provider needed to implement effective systems and processes to monitor the quality of the service and to drive improvement. Audits in place were not always effective in identifying shortfalls.
The provider had not always submitted notifiable incidents in accordance with their legal responsibilities. Immediate action was taken to address this shortfall.
People and those important to them, were involved in planning their care. The registered manager was open and transparent throughout our inspection and demonstrated a commitment to delivering improvements and achieving best outcomes for people. They were receptive to our feedback and took action to address the shortfalls we found.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update. The last rating for the service was good (published 07 December 2016).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well led key question sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lily health care limited on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to the management of risk and how the provider monitors the service provided.
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 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.