First inspection of Homesaints Limited rated Requires Improvement overall, with breaches of Regulations 9, 12 and 17 around person-centred care, risk management and governance. Staff were caring but late visits, unmet meal preferences, weak risk assessments, recruitment record gaps and ineffective audits undermined safety and responsiveness.
Concerns (10)
critical
Missed or late visits
: “There have been times when the [staff] haven't turned up until 8pm to give my [family member] their evening meal. My [family member] says it's too late.”
criticalCare planning: “Risk assessments did not show enough information about 'how' staff should support a person to ensure safety and personal preferences were not always considered.”
criticalPerson-centred care: “People's preferences were not fully explored meaning care was not person-centred. Concerns were not always responded to with a view to improving care.”
criticalGovernance: “Systems were ineffective for assessing and monitoring the quality of care, safety and personal needs of people using the service.”
moderateRecord keeping: “gaps in staff members employment history had not been explored and recorded. This meant the provider could not be assured of the staff members good character”
moderateComplaints handling: “less serious complaints were not being recorded here. This meant it was difficult for the registered manager to analyse complaints for trends.”
moderateStaffing levels: “The rota was not planned in ways that meant care visit times were carried out at times people expected them. This resulted in people believing staff to be late”
moderateEnd-of-life care: “the concept of serious illness, death and dying had not been approached with people or recorded in order for staff to be aware of their wishes”
moderateLeadership: “there were gaps in the registered managers knowledge in relation to current best practice and statutory guidance”
minorMedication management: “care plans were not always clear as to who was responsible for the management and ordering of people's medicines.”
Strengths
· Staff were kind, caring and treated people with dignity and respect
· Staff received safeguarding training and understood how to recognise and report abuse
· Good infection prevention and control practices including PPE use
· Staff completed Care Certificate and received induction, supervision and appraisals
· Registered manager worked in partnership with health and social care professionals
Quality-Statement breakdown (21)
safe: Assessing risk, safety monitoring and management; Staffing and recruitmentRequires improvement
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Preventing and controlling infectionNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot 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: 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: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
responsive: Meeting people's communication needsNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: 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