Care for You (UK) Limited, a small live-in domiciliary agency supporting three people, was rated Good across all five key questions at its February 2015 inspection. The service demonstrated strong person-centred care, well-trained and well-supported staff, effective management oversight, and positive feedback from people and relatives.
Strengths
· Consistent staffing with good retention rates and low sickness levels, providing continuity of care to people
· Comprehensive, person-centred care plans written in partnership with people and their relatives detailing likes, dislikes and preferences
· Regular announced and unannounced spot checks by management to monitor care quality and records
· Staff well-trained including in MCA principles, moving and handling, safeguarding, and medication administration
· 24-hour on-call management support available to staff at all times
Care for You (UK) Limited was rated Requires Improvement overall at its June 2017 inspection, down from Good in 2015, with a regulatory breach found for failing to operate safe recruitment procedures under Regulation 19. Governance, medication record-keeping, and risk assessment processes were ineffective, though care delivery, staff training, and person-centred practice remained Good.
Concerns (6)
criticalStaffing levels: “The registered provider's recruitment procedures were not suitably effective to protect people from unsuitable staff gaining employment.”
moderateRecord keeping: “Records were not always completed by staff to demonstrate they had administered people's medicines as prescribed by a health care professional.”
moderateCare planning: “The risk assessments we saw were not always amended or reviewed in order to provide staff with the necessary guidance and instructions to reflect these changes.”
moderateGovernance: “The systems in place by the provider to monitor, check and review the quality of the service were not effective means in identifying any concerns or shortfalls in people's care.”
moderateMedication management: “The medicine records we saw contained gaps and lines across areas where staff should have signed for items as administered.”
minorSupervision / appraisal: “Some staff believed they received support and guidance however, others did not feel so supported and rather on their own.”
Strengths
· People felt safe and trusted staff implicitly, with consistent live-in care workers building strong relationships with people they supported.
· Staff were trained in areas relevant to people's needs, including specialist training for specific healthcare conditions.
· People's privacy, dignity and independence were respected by staff.
· People were involved in reviewing their care plans and felt their preferences were met.
· An on-call system was in operation outside office hours to ensure continuity of care.
Quality-Statement breakdown (18)
safe: Fit and proper persons employed (Regulation 19)Requires improvement
safe: Medicines management and record keepingRequires improvement
Care for You (UK) Limited improved from Requires Improvement to Good across all five key questions, having remediated a previous breach of Regulation 19 around safe recruitment and strengthened risk assessment and governance processes. The service demonstrated personalised, consistent live-in care with strong staff support structures, though minor gaps remained in competency-check implementation and the detail of some behaviour guidelines.
Concerns (3)
minorStaff competency: “the director told us, they did not follow all the principles of the certificate such as competency checks for each element of the training staff had completed.”
minorCare planning: “we found one person's behaviour guidelines could have been more detailed to include, tips for staff on how to defuse situations before their behaviours escalated.”
minorPerson-centred care: “we identified a situation, where professional boundaries may not have always been upheld. We discussed this with the registered manager who was not fully aware of the situation.”
Strengths
· Staff understood safeguarding responsibilities and knew how to recognise and report signs of abuse.
· Safe recruitment checks were fully completed, resolving the previous breach of Regulation 19.
· Risk assessments were up to date and provided detailed guidance for staff on managing individual risks.
· Medicines were managed safely, with staff trained and assessed as competent; MAR records audited monthly.
· Live-in care model meant staff knew people extremely well, fostering strong continuity of care.
Quality-Statement breakdown (19)
safe: Recruitment checks completed to ensure staff suitabilityGood
safe: Risk assessments in place and up to dateGood
safe: Medicines managed safely with trained and competency-assessed staffGood
safe: Safeguarding training completed; staff know how to report concernsGood
safe: Sufficient staffing levels to meet people's needsGood
effective: Staff training covers essential areas and individual care needsGood
effective: Care Certificate induction completed, though not all competency checks fully implementedGood
effective: Mental Capacity Act principles understood and applied