Senior Health Care Cornwall's first inspection resulted in an overall 'Requires Improvement' rating, with a breach of Regulation 17 (Good Governance) identified due to ineffective governance processes, absent training evidence for supported living staff, and unassessed medicines competency. The service demonstrated strengths in person-centred, compassionate care and responsiveness, achieving 'Good' ratings in caring and responsive domains.
Concerns (6)
criticalGovernance: “Governance processes had not always been used effectively to identify improvements. For example risk assessments did not all have guidance for staff to mitigate risks.”
criticalStaff training: “The registered manager was unable to provide evidence of training for staff who worked at the supported living service.”
criticalStaff competency: “Assessments of the competency of staff who administered medicines had not been completed.”
moderateRecord keeping: “The registered manager told us staff did not administer medicines; however, records completed by staff suggested they did. This had not been identified through checks.”
moderateCare planning: “When people's care plans were taken to the office to be updated, they were not always returned promptly and did not always reflect changes to the person's care needs.”
moderateStaffing levels: “There were gaps in some new staff's employment histories. This meant the registered manager could not be fully assured the staff were suitable to work with vulnerable adults.”
Strengths
· People received kind and compassionate care from staff who protected and respected their privacy and dignity.
· Staff received training in safeguarding and understood who to contact internally and externally if they had any safeguarding concerns.
· People were involved in planning their own care and making decisions about how their needs were met.
· Care and support plans were personalised and reflected people's needs and aspirations.
· Staff worked within the principles of the Mental Capacity Act 2005.
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
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: 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
caring: Respecting and promoting people's privacy, dignity and independenceGood
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: Supporting people to develop and maintain relationships and take part in activitiesGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Engaging and involving people using the service, the public and staffRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood