Lindcare Ltd was rated Requires Improvement overall at this first inspection, with breaches of Regulation 17 (good governance) and Regulation 19 (fit and proper persons employed) due to incomplete recruitment checks, missing DBS and reference records, and a lack of managerial oversight of staffing records. Care delivery was rated Good for effective, caring and responsive, with people reporting kind, person-centred support and safe medicines management.
Concerns (6)
criticalGovernance: “Recruitment checks were not robust; the registered manager had a lack of oversight of staff providing the regulated activity (personal care).”
criticalRecord keeping: “Employment application forms were sometimes missing or incomplete. The registered manager did not carry out checks in relation to gaps in employment history.”
criticalStaff competency: “Staff were deployed without the registered manager being assured of their competence to carry out the role. Training records were not available.”
criticalSafeguarding: “Disclosure and Barring Service (DBS) checks, and right to work checks were not available on inspection.”
moderateLeadership: “The registered manager was unclear how many staff were employed and what role they were contracted to do.”
moderateStaffing levels: “There was no staffing structure made available during the inspection. Staff were unclear about who their line manager was or their role within the service.”
Strengths
· People were kept safe from risk and harm and staff had a good understanding of safeguarding processes.
· Medicines were managed safely by staff who had received training and had their competency assessed.
· Effective infection prevention and control measures were in place.
· Staff were kind, compassionate and caring; they treated people with respect and maintained their privacy and dignity.
· Support plans were person-centred, containing people's likes, dislikes and preferences, and reviewed regularly.
Quality-Statement breakdown (24)
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies; supporting people to access healthcare servicesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service; continuous learning and improving careGood