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Date of assessment: 17 and 18 February 2025. The service is a care at home service providing support to people with dementia, mental health support needs, physical disability, older people, and younger adults. The service had not been assessed or rated before, so we completed a comprehensive assessment. During this assessment, we found 7 breaches of the legal regulations in relation to safeguarding, staffing and training, recruitment and selection, management of medicine and risk, management of complaints, submission of notifications, and governance including record keeping. The provider did not operate effective quality assurance systems to oversee the service. These systems did not identify shortfalls in the quality and safety of the service or ensure that expected standards were met. Feedback from people, relatives, and staff was not consistently used for making improvements to the service. The provider did not ensure consistent actions were taken to reduce risks to people and plans were not always in place to minimise those risks. The provider did not ensure their safeguarding systems were established and operated effectively to investigate any allegations. Effective recruitment processes were not in place to ensure, as far as possible, that people were protected from unsuitable persons being employed. The management of medicines was not safe. Not all staff were up to date with, or had received, their competency checks and mandatory training to be able to support people with different needs. When incidents or accidents happened, they were not fully investigated, and there was little evidence of any lessons learned, or themes and trends reviewed. The provider did not ensure clear and consistent records were kept for people who use the service and the service management. The provider did not inform us about notifiable incidents in a timely manner. Staff deployment was not always managed effectively as people’s visits were not attended and completed as per plans of care. The care plans did not consistently contain information specific to people’s needs and how to manage their care and any conditions they had. Staff did not have detailed guidance for them to follow when supporting people with complex needs. Staff did not always follow correct infection prevention and control processes. This service is being placed in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a time frame within which providers must improve the quality of the care they provide.
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