Archived: Lotus Homecare Sheffield

Lotus Homecare Sheffield is a domiciliary care agency. It provides personal care to people living in their own home. It provides a service to adults with a range of health and social care needs. At the time of our inspection the service was providing personal care for approximately 69 people. 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

At our last inspection people raised concerns about the consistency of care staff supporting them. At this inspection people and relatives raised this concern with us again. People also told us they wanted their calls delivered on time and not to experience late calls. Some people were experiencing short calls and not receiving their planned care. People and relatives told us there were not enough staff to deliver calls on time. This showed the provider had not ensured there was enough staff deployed to ensure people received continuity of care.

People and relatives told us they had contacted the service to complain about their calls being late. However, these concerns about people’s late calls were not always being captured by the complaints process. This showed these informal concerns were not being monitored and used for learning and improvement. We shared this feedback with the regional manager.

The provider had not ensured there was proper and safe management of medicines. We found the systems in place to ensure people received their prescribed medicines at the right time required improvement. Safeguarding procedures were robust and staff understood how to safeguard people. The provider had completed pre-employment checks for new staff, to check they were suitable to work at the service.

People told us they had a written care plan in place. We received mixed views about the quality of care provided by care staff. People told us experiencing late calls and staff being rushed reduced the quality of care they received. People also worried they would not receive a call and did not always feel well supported. This was reflected in the feedback received from relatives.

At our last inspection we found the systems in place where the manager’s monitored and reviewed the quality of the service required improvement. At this inspection, the feedback from people and relatives showed this area still required improvement. The registered manager did not have a sufficient knowledge about quality performance and risks. For example, the real time monitoring of people's calls required improvement.

People and relatives made positive comments about the staff and told us they were caring. Relatives told us most of the care staff treated their family member with dignity and respect.

Staff received a range of training and support relevant to their role. Our findings during the inspection showed some staff required further medication training and their competency re-checked. Staff told us they felt fully supported and listened to.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff understood the importance of respecting people’s diverse needs and promoting independence.

Rating at last inspection

The last rating for this service was requires improvement (published 6 February 2019). The service remains rated requires improvement. The service has been rated requires improvement for the last two consecutive inspections.

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

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Lotus Homecare (Sheffield) is registered to provide personal care to adults with a range of health and social care needs. This was our first inspection of Lotus Homecare (Sheffield) under the registered provider's registration with the Care Quality Commission (CQC).

At the time of the inspection Lotus Homecare (Sheffield) were supporting 70 people with the regulated activity.

There was a manager at the service who was registered with CQC. A registered manager is a person who has registered with CQC 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 and associated Regulations about how the service is run.

People raised concerns about the consistency of the staff that supported them. Some people spoke very positively and told us they felt safe and their care workers were respectful and kind. Where people did not have regular care staff they told us they did not always feel safe, because the care staff did not know their care needs as well as the regular staff. We shared specific concerns with the registered manager who took immediate action to resolve these concerns and improve people's experience.

We found there were systems in place to protect people from the risk of harm. Staff we spoke with could explain the procedures to follow should an allegation of abuse be made. Although there were a couple of examples where staff were not consistently following the providers procedures. The registered manager was aware of this and had addressed these concerns through direct supervision.

We found systems were in place to administer people's medicines safely. The service adhered to the local authority policy for the safe administration of medicines. Systems were monitored and any errors were reported and acted on to prevent reoccurrence.

Assessments identified risks to people, and these were regularly reviewed to ensure people's safety.

Staff were provided with relevant training and supervision to make sure they had the right skills and knowledge to support people. Some staff said they would benefit from additional training in safeguarding vulnerable adults and catheter care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered provider's policies and systems supported this practice. People had consented to receiving care and support from Lotus Homecare (Sheffield).

People were supported to maintain a healthy diet, which considered their culture, needs and preferences, so their health was promoted and choices could be respected.

Some people felt complaining did not improve the service they received as any concerns they raised weren’t responded to or acted upon. People told us they did not always get a response when they telephoned the agency office.

Systems were in place where managers monitored and reviewed the quality of the service provided to people. However, we found that these systems needed further embedding to ensure continuous improvement of the services provided.