Lancaster Leyland Care Limited

Lancaster Leyland Care Limited also known locally as 'Second to None' is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Not everyone using Lancaster Leyland Care Limited receives a regulated activity. Care Quality Commission (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 the service was providing personal care to 40 people who lived in and around St Helens.

At the last inspection in April 2016 the service was rated 'Good'. At this inspection we found the service remained 'Good'. We found the manager and the registered provider had continued to maintain the safe standards of care and to ensure people received good levels of care.

The service was managed by a registered manager who was also one of the directors. 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. The manager used a variety of methods to assess and monitor the quality of care delivered at the service. These included care file audits, regular spot checks, quality surveys, to seek the views of people about the quality of care being provided and staff meetings to seek staff's views and share best practice. However, we found improvements were required to ensure the quality assurance processes in the service were robust. We found shortfalls that had not been identified by the audits.

Recruitment checks were carried out to ensure suitable people were employed to work in the service. People who used the service told us there were sufficient staff to ensure people received the care they required. However, we found rotas needed to be designed to allow visits to be carried out effectively without overlaps and to allow staff adequate time between care visits.

People who used the service told us they felt safe receiving support from Lancaster Leyland Care Limited. Feedback regarding the care quality was positive. There was a safeguarding policy and staff had received safeguarding training.

There were risk assessments to minimise the potential risk of harm to people who used the service. These had been kept under review and were relevant to the care and support people required. However, we noted that risk assessments for people who had medical attachments such as catheters needed to be robust.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. We noted some improvements were required to the processes for monitoring medicines records to ensure audits were undertaken in a systematic way to help the provider to identify where the shortfalls were in a timely manner. The registered manager took action and started putting corrective measures in place.

Care plans were in place detailing how people wished to be supported. People who received support, or where appropriate their relatives, were involved in decisions and consented to their care. However, records of how mental capacity had been assessed had not been completed. We made a recommendation about this. People's independence was promoted.

People were supported to meet their nutritional and hydration needs and they had been assisted to have access to healthcare professionals and their healthcare needs were met.

Risks of infections had been managed. There was an infection control policy and staff had access to personal protective equipment such as gloves.

The provider had regularly sought people's opinions on the quality of care provided.

People and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available, and we saw how previous concerns had been dealt with.

Staff had received induction and training. There was a policy on staff supervision and appraisals and staff had received regular supervision. The majority of the staff told us there was a positive culture within the service. They told us they enjoyed their work. However, two of the staff we spoke with told us they did not feel the rotas were effectively organised to give them time to travel between visits and did not feel they could always contribute to the effective running of the service. The registered manager informed us they would address these concerns with all staff.

The manager used a variety of methods to assess and monitor the quality of care delivered at the service. These included care file audits, regular spot checks, quality surveys, to seek the views of people about the quality of care being provided and staff meetings to seek staff's views and share best practice.

The five questions we ask about services and what we found