Independent Living Home Care

Updated 10 October 2019

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

The inspection was carried out 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 was run by a single provider in day to day control of the service. It was therefore not required to have a registered manager. This means the provider is 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 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider would be in the office to support the inspection.

Inspection activity started on 26 July and ended on 6 August 2019. We visited the office location on 6 August 2019.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority who works with the service. 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 used all of this information to plan our inspection.

During the inspection

We looked at four people’s care and medication administration records. We looked at one staff recruitment record and two staff training and supervision documents. We viewed a range of records relating to the management of the service including audits and team meeting minutes.

We visited two people who used the service and one relative. We received feedback from two relatives by telephone and email. We spoke with the provider and two care staff.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and the provider’s policies and procedures. We spoke with one social care professional who works with the service.

Updated 10 October 2019

About the service

Independent Living Home Care is a domiciliary care service providing personal care. The service was supporting five people at the time our inspection, including those living with dementia, older people and younger people.

Not everyone who used the service received personal care. The Care Quality Commission (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 at risk of avoidable harm because the provider lacked understanding of their responsibilities and regulatory requirements. They did not have robust systems in place to check safety and quality across the service including with staff training and people’s records. The provider had not acted on issues we identified at the last inspection of the service.

Despite the potential for risk, we found evidence of some improvements and the service achieved positive outcomes for people. The provider had a positive approach to risk management, this enabled people to remain independent living in their own homes. People were encouraged to manage their own medicines where possible. The provider was not always aware of best practice guidance for medicines.

People were satisfied with the effective care they received. Staff worked effectively with healthcare professionals, other care providers and relatives to ensure people’s care needs were met.

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 did not support this practice.

People were treated with dignity and respect. Staff ensured they were at the centre of decision-making about their care. The thoughtful, caring approach staff used improved people’s wellbeing and helped them to take pride in their appearance.

People received a personalised service reflecting their needs and preferences. The provider worked flexibly to provide support. People and their relatives were confident they could raise any issues with the provider and that these would be listened to.

We made recommendations about medicines, the Mental Capacity Act 2005 and end of life care planning.

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 this service was requires improvement (published 27 July 2018).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had been made and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the governance 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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.