First inspection of a newly registered domiciliary care service supporting one person, rated Good overall with Well-led rated Requires Improvement. Quality assurance, staff competency assessments, medicines protocols and COVID-19 monitoring systems needed further development before the service expanded.
Concerns (7)
moderate
Governance
: “Some of the provider's quality assurance systems, policies and business contingency plan needed to be further developed to ensure they had clear systems in place to safely manage and monitor the service”
moderateStaff competency: “a comprehensive assessment of staff skills including medicines management and manual handling competencies was needed to assure the registered manager that staff practices were current and safe”
moderateMedication management: “They agreed to take immediate action and obtain a record of a medical practitioner's consent for staff to administer homely medicines such as non-prescribed creams.”
moderateInfection control: “the registered manager had not implemented a system to monitor the regularity of staff testing and the results. This meant they could not be assured that people were being supported in line with government COVID-19 guidance”
minorStaff training: “The registered manager was sourcing additional practical training to supplement staff's eLearning training and was implementing competency assessments to check staff practices.”
minorEnd-of-life care: “The registered manager said they planned to review and implement end of life care plans, policies and staff training before they would support people with end of life care needs.”
minorCare planning: “staff would benefit from some information about people's risks and management of homely remedies (over the counter medicines) such as creams.”
Strengths
· Staff praised as kind, compassionate and attentive; person felt safe with staff
· Care plans were comprehensive and person-centred
· Safe recruitment practices followed
· Staff trained in safeguarding with access to whistleblowing policies
· Effective induction and Care Certificate completion for new staff
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and management; Using medicines safelyNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot 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; supporting people to access healthcare servicesNot 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
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot 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: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Continuous learning and improving careNot rated
well-led: Working in partnership with othersNot rated