Loyal Care Consortium was rated Requires Improvement overall, with breaches of Regulations 9, 12 and 17 relating to person-centred care, safe care and treatment, and good governance. Risk assessments and care plans lacked detail and personalisation, MCA principles were not followed, and quality assurance failed to identify shortfalls, though recruitment, safeguarding, infection control and complaints handling were satisfactory.
Concerns (10)
criticalCare planning — “Care plans lacked detail how people's individual care needs were best met and were not person centred.”
criticalPerson-centred care — “We viewed eight care plans and found that they all lacked detail and personalisation. The service used the same template for all people which had identified the same six needs.”
criticalIncident learning — “Accidents and incidents were not always documented in a timely manner and trends and patterns were not analysed and action taken.”
criticalGovernance — “The service internal monitoring system from July 2022 to September 2022 did not highlight the shortfalls in the management of risk and planning of person-centred care”
criticalConsent / capacity — “The service was not working within the principles of the MCA. We found little evidence that the service had undertaken assessments of people's capacity”
moderateMedication management — “risk assessments for people who received support around their medicines were not always comprehensive and lacked the necessary information for staff to support people safely with their medicines.”
moderateRecord keeping — “one risk assessment from December 2019 had not been reviewed or updated. Therefore, it was not clear if the person's changing needs had been addressed”
moderateMissed or late visits — “we found evidence of 'call cramming', which meant care workers did not have sufficient travel time.”
moderateLeadership — “The service lacked a positive person centred, open, inclusive and empowering culture.”
minorCommunication with families — “one care plan stated that the person was hard of hearing but there was no further information how the person was supported around this.”
Strengths
· Safe recruitment with DBS and reference checks in place
· Sufficient staff deployed to meet people's needs
· Effective infection control practices including COVID-19 measures
· Robust safeguarding procedures with trained staff
· Staff received wide-ranging training including manual handling, medicines and safeguarding
Quality-Statement breakdown (21)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standardsRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietRequires improvement
effective: Staff working with other agencies to provide consistent, effective, timely careRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Staff support: induction, training, skills and experienceGood
responsive: Planning personalised care to ensure people have choice and controlRequires improvement
responsive: Meeting people's communication needsRequires improvement
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
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 empoweringRequires improvement
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood