Limms Care Services Limited

The registered manager did not ensure consistent actions were taken to reduce the risks where possible and plans were not in place to minimise those risks. Effective recruitment processes were not in place to ensure that people were protected from staff being employed who were not suitable. The management of medicines was not always safe. Staff were not up to date with, or had not received, their competency checks and mandatory training. Staff did not have ongoing support via regular supervision and appraisals. Complaints were not managed effectively or according to the provider's policy. Not all people knew how to raise a complaint or concern with the provider or knew where the contact details were to raise a complaint.

When incidents or accidents happened, it was not recorded or clear that it was fully investigated, and if lessons were learnt. The registered manager did not ensure that clear and consistent records were kept for people who use the service and the service management. The registered manager did not inform us about notifiable incidents in a timely manner. Staff deployment and management of visits did not always ensure people received their care as planned. People and relatives were not consistently informed about the changes to their visits or the staff being late. People and relatives told us the times of visits were not always kept according to the care plan. People, their families and other people that mattered were involved in the planning of their care. However, the care plans did not contain information specific to people's needs and how to manage any conditions they had. Staff did not have much detailed guidance for them to follow when supporting people with complex needs.

We have made a recommendation about seeking guidance from a reputable source to ensure the MCA legal framework and provider's responsibilities to record people's decisions was followed accordingly.

We have made a recommendation about seeking guidance from a reputable source to ensure the principles of the Accessible Information Standard were met.

People reported they felt safe with the staff providing their support and care. Relatives agreed they had no

issues with people's safety. Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. The staff team followed procedures and practices to control the spread of infection using personal protective equipment. People and their relatives who provided feedback said people were treated with care, respect, and kindness by the staff visiting them. Staff always upheld people's privacy and responded in a way that maintained people's dignity. People and relatives said that staff were consistent and effective in the support they provided. Staff said the staffing levels were sufficient to do their job safely and effectively.

We judged people were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests. However, the policies and systems in the service had to be improved to continue supporting this practice. The registered manager appreciated staff team's contributions and efforts to ensure people received the care and support. Staff felt they could approach the registered manager at anytime, and they communicated regularly with each other. The staff team felt supported by the registered manager and worked well together.

The management team was working with the local authority and different professionals to investigate safeguarding cases and other matters relating to people's health and wellbeing. There was an emergency plan in place to respond to unexpected events.