Paxigate Healthcare Limited, a small domiciliary care agency, was rated Requires Improvement overall on its first inspection, with safe and well-led both requiring improvement due to incomplete pre-employment DBS checks and references that the governance system had failed to identify. Care delivery across effective, caring, and responsive domains was rated Good, with relatives consistently praising staff as kind, professional, and person-centred.
Concerns (2)
criticalStaffing levels: “The required pre-employment checks had not been fully completed to help ensure staff employed were suitable. This included completing a new Disclosure and Barring Service (DBS) check and obtaining additional references.”
moderateGovernance: “Quality assurance systems had not always identified shortfalls found during our inspection. For example, in relation to the recruitment practice.”
Strengths
· Relatives consistently reported people felt safe and well supported by kind, caring staff
· Risk assessments were completed at service start and regularly reviewed with clear instructions for staff
· Medicines were managed safely with audits of administration records in place
· Staff received appropriate training including specialised topics such as Parkinson's disease support
· Care plans were personalised, regularly reviewed, and developed collaboratively with people and relatives
Quality-Statement breakdown (21)
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuse; Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely care; Supporting people to live healthier livesGood
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 to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staff; Continuous learning and improving careGood