This first focused inspection of Loidis Care Services rated Safe as Requires Improvement due to incomplete risk assessments, gaps in PRN medication recording, and weaknesses in recruitment checks. Well-led was rated Good, reflecting an approachable registered manager, positive relative feedback, and willingness to learn, though quality assurance effectiveness needed strengthening.
Concerns (5)
moderateCare planning: “some risks to people's care had not been recorded or the risk assessments were not detailed... moving and handling risk assessments had not been completed”
moderateMedication management: “one person's 'as and when required' medicine protocol lacked detail in relation to the time between dosages; this is important to ensure people do not overdose”
moderate
Staff competency
: “The service did not always follow safe recruitment practices. Evidence of pre employment checks before commencement of employment had not always been retained.”
moderateGovernance: “quality assurance processes... had not always been effective in identifying some of the issues found at this inspection”
minorRecord keeping: “Another person's body map lacked detail in relation to where to apply their prescribed cream.”
Strengths
· Positive relative feedback about caring registered manager and team
· Care delivered by small consistent team with no missed or late visits
· Staff knowledgeable about safeguarding procedures and reporting
· Robust infection control practices including Covid-19 mitigation plans
· Strong partnership working with district nurses, palliative nurses and occupational therapists
Quality-Statement breakdown (9)
safe: Assessing risk, safety monitoring and managementNot rated
safe: Using medicines safelyNot rated
safe: Staffing and recruitmentNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Preventing and controlling infectionNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Working in partnership with othersNot rated
Loidis Care Services, a small domiciliary care agency supporting five people, was rated Good overall but Requires Improvement in Safe due to ongoing issues with PRN medication recording, risk assessment documentation, and an unreported safeguarding incident. The registered manager was responsive to feedback and the service demonstrated strong person-centred care, end of life support, and positive feedback from people and relatives.
Concerns (7)
criticalSafeguarding: “we had to ask the registered manager to make a safeguarding referral due to one allegation made by a relative of unsafe moving and handling manoeuvre performed by staff”
moderateMedication management: “improvements continued to be required in the recording of 'as and when required' medication”
moderateIncident learning: “There had been one safeguarding incident the registered manager had not reported to the Care Quality Commission in line with their responsibilities.”
moderateCare planning: “Improvements continued to be required in how risks to people's care were recorded.”
moderateRecord keeping: “there wasn't a specific risk assessment for this risk”
moderateGovernance: “Medication audits were taking place regularly however these had not identified the issue found with the two PRN protocols.”
minorSupervision / appraisal: “spot checks were done regularly however, supervisions were not always completed for all staff members.”
Strengths
· Staff trained in safeguarding and able to identify signs of abuse and neglect
· Safe recruitment with DBS checks, references and tailored interviews
· Person-centred care planning that considers diverse needs, religious beliefs and gender preferences for carers
· Positive feedback from people and relatives about kind, caring staff and approachable registered manager
· Effective end of life care with anticipatory medication and partnership working with healthcare professionals
Quality-Statement breakdown (21)
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
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 diet
Good
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
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
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: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Continuous learning and improving careGood