Yourlife (Leyland) received a Good rating across all five key questions at its first inspection in January 2023, with people reporting kind, reliable and person-centred care. Key recommendations were made to strengthen governance systems, including consistent monitoring of accidents and incidents for trends and formal recording of quality oversight.
Concerns (5)
moderate
Incident learning
: “they were not consistently monitored to identify lessons learned, themes or trends. The registered manager acted during the inspection to address the completion of records”
moderateGovernance: “no audits were in place to monitor accidents and incidents to establish if trends or themes were happening that needed to be addressed or lessons to be learned”
minorRecord keeping: “Recruitment systems and processes were in place however some records were not consistently completed with required information.”
minorMedication management: “We found two medicines that did not have the protocols in place. During our visit the registered manager completed the relevant missing protocols.”
minorGovernance: “their views were not always analysed to give direction of where improvements could be made.”
Strengths
· People reported feeling safe and spoke positively about staff reliability and consistency of visit times.
· Staff trained in safeguarding, medicines administration, and competencies regularly checked.
· Person-centred care plans developed with involvement of people and their relatives.
· Effective partnership working with multidisciplinary community health professionals.
· Positive feedback about registered manager's leadership, approachability and responsiveness.
Quality-Statement breakdown (21)
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongNot rated
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
responsive: Planning personalised care to ensure people have choice and controlNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
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 requirementsNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Continuous learning and improving care; Promoting a positive cultureNot rated
well-led: Working in partnership with othersNot rated
well-led: How the provider understands and acts on the duty of candourNot rated