First inspection of LCS Portsmouth identified breaches of Regulations 11, 12, 17 and 19 covering MCA, risk assessment, medicines management, governance and recruitment, resulting in an overall rating of Requires Improvement. Although staff were consistently described as kind and caring, ineffective quality monitoring placed people at risk of harm.
Concerns (11)
critical
Care planning
: “Not all risks for people had been fully assessed and plans put in place to mitigate those risks as far as possible.”
criticalMedication management: “Staff had not been assessed as competent to administer medicines safely. Procedures were not in place or followed to ensure medicines were always been managed safely.”
criticalConsent / capacity: “Suitable procedures were not in place to ensure people's rights under the MCA were recognised and ensured.”
criticalGovernance: “The provider's quality assurance processes were not effective and had failed to identify concerns we found and improve the quality and safety of the services provided.”
criticalRecord keeping: “MARs charts for specific people whose care plans we had reviewed we were told these were not available as they had not been returned to the office”
criticalOther: “The registered person has failed to ensure that all necessary pre employment checks were completed.”
moderateStaff competency: “no assessments of staffs understanding of the online training and how this should be put into practice such as medicines or moving and handling competencies had been undertaken”
moderateSupervision / appraisal: “there were no supervision records for the other four staff whose files were viewed... The provider was therefore not following their own procedures”
moderateComplaints handling: “the failure to formally record these meant patterns or trends may be missed and action not taken to reduce the likelihood of similar concerns”
moderateCommunication with families: “They [Lone Care Services] put two people with him that can`t speak or understand English so I can`t go out!”
moderateLeadership: “Most people or their family members were unsure who the registered manager was. Several named an office staff member who they thought was the manager.”
Strengths
· People and family members described staff as kind, caring and respectful, with positive established relationships
· Staff were knowledgeable about safeguarding responsibilities and people reported feeling safe
· Appropriate PPE and infection prevention and control arrangements were in place
· People were treated with dignity and respect and supported to maintain independence
· External professionals reported positive, responsive working relationships with the service
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Learning lessons when things go wrongNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot 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: Staff working with other agencies; supporting people to access healthcare servicesNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot 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: Working in partnership with othersNot rated