Lionheart Domiciliary Care Services Limited - Deptford

Lionheart Domiciliary Care Services Limited - Deptford is a domiciliary care agency. The service provides personal care to people living in their own homes.

Not everyone who used the service received personal care. In this service, the Care Quality Commission can only inspect the service received by people who get support with personal care. This includes help with tasks related to personal hygiene and eating. Where people receive such support, we also consider any wider social care provided. At the time of our inspection there were 36 people receiving personal care support.

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

People and their relatives were positive about the care they received. We received comments such as, “They do anything the clients want. I think they have gone that extra mile for us, that makes me feel happy” and “I would recommend them, they are punctual and they make sure I have a cup of coffee.”

Despite this positive feedback we identified issues with the quality and safety of the service. People’s medicines were not always administered safely and in line with best practice. The provider did not follow safe recruitment procedures.

There were quality assurance systems and processes in place, however, they had not identified the issues we found. Staff were positive about the support they received to fulfil their role. The provider sought regular feedback from people about the care they received. The provider worked in partnership with a range of health and social care professionals to plan and deliver care and support.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good (report published 28 September 2018).

Why we inspected

We were prompted to carry out this inspection due to concerns we received about staffing and recruitment. As a result, 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 this service has changed from good to requires improvement based on the findings of this inspection. You can see what action we have asked the provider to take at the end of this full report.

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 and will take further action if needed.

We have identified breaches in relation to recruitment, medicines and good governance. Please see the action we have told the provider to take at the end of the full version 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.

Lionheart Domiciliary Care Services Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At our last inspection we did not have adequate information about the experiences of enough people using the service to give a rating to each of the five questions and an overall rating for the service.

There was a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were supported by staff who knew how to protect them from the risk of harm. Staff followed safeguarding procedures to identify and report any concerns. Risks to people’s safety and well-being were assessed and managed. Staff reported incidents and were encouraged to learn from their mistakes to minimise a recurrence.

There were sufficient skilled and experienced staff deployed to meet people’s needs. The provider carried out appropriate recruitment procedures to ensure only staff suitable to deliver care worked at the service. People received the support they required to take their medicines. Staff followed good hygiene practices to minimise the risk of infection.

People received care in line with best practice guidance. People’s needs were assessed and care delivery planned before they started using the service. Health and social care professionals were involved in planning people’s support in line with current guidance. Staff received the support, training and supervision required to undertake their roles. People were supported in line with the requirements of the Mental Capacity Act 2005.

People were involved in planning and making decisions about their care. People consented to care and support. Staff treated people with dignity and respect.

Care and support plans were reviewed and updated to ensure staff had sufficient guidance about how to meet people’s needs. People’s care delivery responded to changes in their health and well-being.

People were supported to maintain good health and to access healthcare services when needed. People received the support they required to eat healthily and to maintain a healthy lifestyle.

People using the service and their relatives were encouraged to share their views about the quality of care. Feedback received was used to make improvements and develop the service.

The quality of care was checked and audited to identify any areas of improvement. Shortfalls identified were addressed in a timely manner.

People benefitted from the registered manager’s close partnership with other agencies. People using the service and their relatives spoke positively about the registered manager and staff.

The service had provided care and support to people for a limited time. We did not have enough information about the experiences of a sufficient number of people using the service to give a rating to each of the five questions and an overall rating for the service.

This is the first inspection of the service since registration with the Care Quality Commission in August 2016. Prior to this, the service was registered at a different address.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People using the service received safe care and support in their homes. Care workers and coordinators knew about the identified risks to people’s health and well-being and had sufficient guidance on how to provide safe care and support. Safeguarding systems were in place and care workers knew how to identify and report abuse to keep people safe.

People received care and support as planned. There were sufficient numbers of staff deployed to meet people’s needs. People were supported to take their medicines safely. Staff minimised the risk of infection to people by following good hygienic practices.

Staff were supported in their roles and received supervision and training to develop their practice.

People consented to care and treatment. Staff provided people’s care in line with the legal requirements of the Mental Capacity Act 2005.

People who required support with eating and drinking received the assistance they required. Staff supported people to access healthcare services when needed.

People using the service and their relatives commented positively about the caring, dignified and respectful manner in which care workers provided care. People were involved in planning and making decisions about their care and support.

The registered manager assessed people’s needs and planned for care delivery before and after they started to use the service. Support plans were in place for staff about how to deliver care to people.

People using the service and their relatives were able to share their views about the care. The registered manager considered their feedback to develop the service. People knew how to make a complaint or raise any concerns if they were unhappy about the service.

Quality assurance systems were in place to monitor care provided. The service had operated for a limited time and it was too early for us to determine the effectiveness of the audits and monitoring checks at the time of inspection.

The registered manager was testing a system to monitor staff’s punctuality and time spent in people’s homes to minimise the risk of missed calls and lack of delivery of appropriate care. It was too early to assess the effectiveness of this system at the time of inspection.