Sarah Care Limited was rated Requires Improvement overall, with a breach of Regulation 17 (good governance) due to inadequate recording of medicines support, particularly prompts, and gaps in risk assessment that the quality assurance system failed to identify. Effective, caring and responsive domains were rated Good, with positive feedback about kind staff, person-centred care, regular care workers and an open, well-supported culture.
Concerns (6)
criticalMedication management: “Staff did not always record prompts given with individual medicines and the service did not always gather information about the medicines people were taking when staff prompted with medicines.”
criticalRecord keeping: “a complete and contemporaneous record of the support provided with medicines was not always maintained.”
criticalGovernance: “The systems and processes used by the service had not identified the issues we found with the recording of medicines support or the assessment of risk”
moderateCare planning: “In some care plans we checked, not all risks had been adequately assessed and documented. Some risk management measures were not detailed enough.”
minorPerson-centred care: “some care records would benefit from further detail about people's life history, likes and dislikes as this would support new staff to provide more personalised care”
minorConsent / capacity: “the service did not retain a copy of the LPA in the person's care file. We recommend the service obtains a copy to ensure staff have clear information”
Strengths
· People felt safe and staff were trained in safeguarding adults from abuse
· Staff were kind, caring and delivered person-centred care; people felt well-treated and respected
· People usually received care from regular care workers who arrived on time and stayed the correct length of time
· Open, welcoming, positive culture with effective teamwork and communication
· Staff received a wide range of training and felt very well supported by the registered managers
Quality-Statement breakdown (21)
safe: Using medicines safelyNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Learning lessons when things go wrongNot rated
safe: Preventing and controlling infectionNot 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 to provide consistent, effective, timely careNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot 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 meet people's needs, preferences, interests and give them choice and controlNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Planning and promoting person-centred, high-quality care and support with openness; duty of candourNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Working in partnership with othersNot rated
Sarah Care Limited improved from requires improvement to Good overall, with Caring rated Outstanding due to exceptionally compassionate, person-centred staff. Previous breach of regulation 17 around medication records had been resolved, though minor concerns remained about rota changes and occasional late calls.
Concerns (3)
minorStaffing levels: “some staff told us their rotas had been frequently changed due to staff unexpected absence. A few staff told us these constant changes had affected their home life.”
minorMissed or late visits: “People told us staff arrived on time, but on the odd occasion care staff may be running late.”
minorCommunication with families: “Two people felt they could have been provided with more information about their calls.”
Strengths
· Exceptionally compassionate and kind staff who built strong, meaningful relationships with people
· Strong, visible person-centred culture with emphasis on equality, diversity and human rights
· Bespoke communication plans with information available in large print and Braille
· Improved medication management with regular MAR checks and staff competency assessments
· Effective governance and quality monitoring by registered managers
Quality-Statement breakdown (13)
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Learning lessons when things go wrongNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot 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 care