Lizor Care

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We reviewed all 8 of the quality statements for this key question.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives told us the service had improved over the past 6 months and there was a recognition from management to learn from mistakes made.

Management teams told us all incidents were reviewed to identify any actions that could be taken to prevent harm. Staff were also aware of the need to reflect and learn from errors. One member of staff told us, “There is always opportunity to learn from our mistakes. I am glad to be corrected to avoid future occurrence.”

Systems were effective to manage incidents and accidents. Staff recorded all incidents and immediate actions taken to keep people safe, for example, if emergency services were called. A further review was completed to make sure the risk of recurrence was minimised. There was a culture at the service of all levels of management being involved with reviews.

People and relatives told us when people started using the service an assessment of their needs was completed. One person told us, “The assessment was organised before I left hospital and then someone came round and talked to me when I was home. It was brilliant.”

The manager told us paper copies of people’s care plans were available in people’s homes and these could go with the person in the event of an admission to hospital. The manager told us, “Staff will stay with people until they go into hospital. The digital care plan gets printed and goes to people’s homes, this can go to the hospital.”

Professionals told us staff had been to assess people prior to agreeing any packages of care. Professionals told us staff were reliable which helped provide a continuity and keep people safe. One professional told us, “Staff are available and very helpful. I find the staff are engaging and reliable. They do what they say they are going to do. They are happy to do it and fulfil their promise.”

Systems had been established to make sure any new packages of care were fully assessed before the service agreed to provide care. The management worked with a range of healthcare professionals to make sure people were safe when moving between services.

People told us they felt safe with staff. People trusted their care workers to provide them with safe care.

Staff told us they had received safeguarding training and were aware of safeguarding processes. Staff knew how to report any safeguarding concerns and they were confident management would take any appropriate actions. One member of staff told us, “Safeguarding is ensuring that clients are safe from any type of harm or abuse. I would directly report to my supervisor or ring the office. We are supposed to be observant, know the client, and report any changes. I do report anything I notice, any form of harm or abuse, I report to my supervisor.”

Safeguarding systems had been effective in reporting all safeguarding incidents to the local authority. Staff were provided with safeguarding training and had access to a safeguarding policy outlining procedures to follow. The manager monitored safeguarding concerns working with the local authority safeguarding teams to resolve cases in a timely manner.

People and relatives told us staff were competent in supporting them to manage risks. One relative told us they thought the new manager had improved how staff managed risk due to more frequent checks of records. They told us, “They [management] are picking up carers if they have not done the details or signed off risk assessments. I feel they are giving [relative] the care they need. They [staff] are all checking on each other.”

Staff spoke with us about risks to people’s safety and demonstrated an understanding of the common risks people had. Staff knew where to access guidance on safe systems of work and told us they reported any changes to office staff for records to be updated.

At our last inspection in October 2023, we found risks were not being managed safely. During this assessment records demonstrated improvement had been made to identify, record and mitigate risks to people’s safety. The manager had reviewed all risk management plans and made sure guidance was up to date and accurate. Whilst improvement was seen there was further improvement required. People who had an air mattress did not have guidance for staff to know what setting their mattress should be on. People with wounds or pressure ulcers being managed by community nurses had no details of the wound recorded. Whilst staff were not responsible for management of the wound, there was no guidance for staff to know when to call community nurses should there be any concerns with people’s bandages and dressings. The manager told us they would add this detail to people’s risk management plans.

People and relatives told us staff used equipment safely. One relative told us how the manager had listened to their concerns about equipment and been responsive in taking action. This approach had made the relative feel the person was safe.

Staff assessed people’s environments prior to any care packages starting. The manager told us they were not responsible for maintaining equipment, but they knew to check it was safe prior to using it.

Records demonstrated environmental risk assessments had been completed and any hazards identified. This enabled guidance for staff to be recorded on how to minimise risks. Where people had equipment to use guidance had been obtained from professionals involved such as occupational therapists.

People and relatives told us there were enough staff available to support people safely. People thought staff were well trained and understood their duties. People told us staff were on time for their visits.

Staff told us they had a thorough induction and regular follow up training for their role. Staff told us when they started work, they were able to work alongside more experienced staff which they found beneficial for their learning. One member of staff told us, “I read the policies, and I did the training. I did shadow shifts for about 3 or 4 days. That was very helpful, without it I would have felt shaky. I learned everything I needed to know. Having the 1-1 experience with the carer who knew people and I could learn from them. I am glad for it.”

At our last inspection we found the required pre-employment checks had not been completed. During this assessment we found improvement had been completed and the required pre-employment checks had been completed for staff before starting work. This included a check with the Disclosure and Barring Service (DBS). The manager had made sure all new staff received an induction when they started work. Staff were also provided with further training and support such as supervisions and regular staff meetings.

People and relatives had no concerns about infection prevention and control and told us staff consistently used personal protective equipment.

Staff told us they had been provided with training on infection prevention and control and had access to guidance. Staff had access to stock of personal protective equipment (PPE). One member of staff told us, “I do get enough PPE to support me. I go to the office for PPE, and we do get sanitisers. This helps to protect us and the clients.”

The provider had an infection prevention and control policy, which was regularly reviewed and updated to reflect current guidance. The management team completed checks to ensure staff were putting the procedures and their training into practice.

People had support from staff to manage their medicines. People and relatives did not share any concerns about how staff administered or managed medicines.

Staff told us they felt confident administering medicines and knew how to report any concerns. Team leaders told us they were carrying out daily medicines checks and identifying any medicines concerns in a timely way.

At our last inspection we found medicines were not being managed safely. During this assessment we found improvement had been carried out and people had their medicines as prescribed. People had their own medicines administration record which recorded all their medicines information. Those we reviewed had no gaps in recording and clear guidance for staff to know how to administer specific medicines. Medicines training was provided to staff and a competence check was carried out to make sure staff had the skills needed. One member of staff told us, “We do assess medicines competence and we supervise staff and observe them administering medicines.”