Lalis Direct Care Ltd

Updated 21 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 8 January 2019 and was announced. We gave the service 48 hours’ notice of the inspection visit because we needed to be sure the registered manager would be in the office care so we could review the records and to provide the information we required.

Two inspectors carried out this inspection and visited the office on the 8 January 2019 to review records and information stored there. An expert with experience made phone calls to people and their relatives on 10 January 2019. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we reviewed information we held about the service. The provider had completed an action plan to tell us how they would meet the breaches found at the previous inspection. The registered manager had completed a Provider Information Return (PIR) on 6 December 2018. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. In addition, we had reviewed notifications we had received. A notification is information about important events that the provider is required to send us by law. We also looked at feedback we had received from two commissioning bodies that had visited and reviewed the service.

During our inspection we reviewed five people’s care records. This included their care plans, risk assessments, daily notes and medicines administration records. We reviewed three staff personnel files. This included their recruitment, training, and supervision records. We spoke with four care staff. We met the care manager and the care co-ordinator and the office administrator. We spoke briefly with the registered manager, however, they had to leave the office after a short while. Therefore, we spoke primarily to the director and compliance manager during the inspection.

Following our inspection, the expert by experience spoke with three relatives and six people who used this service.

Updated 21 February 2019

This announced inspection took place on 8 January 2019.

At our last inspection carried out on 6 and 18 October 2017 we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations. These were for not acting on complaints and for good governance. At this inspection we found that these had been addressed by the provider.

Following the last inspection, we asked the provider to complete an action plan to show what they would do improve the key questions of responsive and well-led to at least good.

During this inspection we found that the provider had improved their systems to enable people and relatives to make complaints and had responded appropriately in addressing their concerns to their satisfaction. During our previous inspection we had found that care calls monitoring was not effective in identifying missed and late calls and some people had complained about this when we spoke with them. During this inspection we found that the provider now had an electronic call monitoring system linked to the local authority, that flagged missed and late calls. This was monitored by the office staff who ensured care calls took place as scheduled. In addition, the provider had employed a compliance manager to check the quality of the service provided and to introduce improved systems and paperwork.

This service is a domiciliary care agency and provides personal care to people living in their own houses and flats in the community. It provides a service to older adults some of whom are living with dementia, and younger disabled adults.

Not everyone using Lalis Direct Care Ltd receives regulated activity; 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 the time of our inspection 32 people were receiving the regulated service of personal care.

There was a registered manager in post. 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.

We found that people and relatives spoke positively about the care they received. They described staff as caring, kind, respectful and polite. They told us staff gave them a choice about their care and support and communicated well with them. They were happy with the service provided and several people stated they would recommend the provider to other people.

People signed their care plans to show they had given consent to the care and treatment stated. The provider had arrangements to ensure that the principles of the Mental Capacity Act 2005 were followed, but on a few occasions mental capacity assessments were not being carried out according to these principles. The provider addressed these when we pointed this out.

People and relatives confirmed care was provided as they wanted it to be done and that their care packages were reviewed with them on a regular basis by the office staff. People had care plans that were person centred and care provision was personalised. We found that some people’s care records did not always contain comprehensive information about their background or diverse needs We brought this to the director’s attention who told us they were updating people’s care plans as they reviewed them. Staff had received diversity training and could tell us how they supported people to meet their diverse needs.

The provider undertook assessments to identify risks to people and put in place guidance for staff to mitigate the identified risks. When people had health conditions such as diabetes there was also guidance for staff so they could take appropriate action where necessary. We found staff had contacted people’s GP, district nurses or emergency services appropriately when they found people were unwell or had fallen.

Staff received an induction and training to support them in their role. They told us the registered manager was supportive and approachable as were the office management team.

Staff who administered medicines received training and all medicines records reviewed were completed appropriately. People’s records contained information about their medicines and possible side effects for staff reference.

Staff had received safeguarding adult and child protection training and told us how they would recognise signs of abuse and report concerns appropriately.

The registered manager, director and compliance manager tracked, safeguarding concerns and incidents and accidents and reviewed people’s records, daily notes and medicines administration records to monitor and improve the quality of the service provided.

The provider worked with commissioning bodies to improve the quality of service provided and to ensure its future sustainability.