ReadyCQC, a weekly field guide to CQC home-care regulation

Inspection report · 2024-03-06

Framework: KLOE · 20 pages · 105 KB · PDF

Requires improvement

safe: Requires improvementeffective: Requires improvementcaring: Goodresponsive: Requires improvementwell-led: Inadequate

Mathalie Care Services was rated Requires Improvement overall (Inadequate for well-led) at its July–September 2023 inspection, remaining in breach of Regulations 9, 12, 17 and 18 due to persistent failures in medicines records, care planning, staff supervision, training, and quality assurance systems. The service was placed in special measures, having recorded an Inadequate rating across two consecutive inspections, though caring improved to Good and safe and effective both improved from Inadequate.

Concerns (9)

criticalMedication management: “Staff had ticked medicines records to show these were given and had not initialled the records to identify who had given medicines or prompted people to take their medicines.”
criticalCare planning: “People's care plans and risk assessments did not always include guidance for staff on how to effectively support people when delivering care and support.”
criticalRecord keeping: “Care plans were neither dated nor signed and the provider had not maintained a record of care plan reviews.”
criticalGovernance: “The provider had not implemented their quality assurance and management policy. The provider's quality assurance systems did not identify the concerns we found on the inspection.”
criticalSupervision / appraisal: “Staff supervisions had not been recorded. It was unclear how the provider was assured that staff were receiving the support they needed.”
criticalLeadership: “There were widespread and significant shortfalls in service leadership. Leaders and the culture they created did not assure the delivery of high-quality care.”
moderateStaff training: “The training matrix showed only 1 staff member had completed safeguarding training...staff had not received training in the Mental Capacity Act 2005.”
moderateConsent / capacity: “There was limited information and guidance about each person's capacity and ability to make particular decisions in relation to their care and support.”
moderatePerson-centred care: “There was limited information about people's background and preferences...this section was not included in the other care records that were provided to us.”

Strengths

· People's relatives told us staff provided care and support in a respectful and professional way.
· Staff were safely recruited with up-to-date DBS checks, references and right to work documentation.
· Staff demonstrated a good understanding of people's care needs and how to meet them.
· 2 staff had completed the Care Certificate and some staff had received specialist training.
· WhatsApp groups were set up for each person to enable timely sharing of care information among staff.

Quality-Statement breakdown (20)

safe: Using medicines safelyRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
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 lawRequires improvement
effective: Staff support: induction, training, skills and experienceRequires improvement

Inspection report · 2022-09-13

Framework: KLOE · 19 pages · 102 KB · PDF

Inadequate

safe: Inadequateeffective: Inadequatecaring: Requires improvementresponsive: Requires improvementwell-led: Inadequate

First inspection of The Havelock Hub identified five regulatory breaches (safe care, medicines, person-centred care, recruitment and good governance) with widespread shortfalls in staff recruitment, training, risk assessments and quality assurance. The service was rated Inadequate overall and placed into special measures.

Concerns (13)

criticalGovernance: “the registered person had not operated an effective system to enable them to assess, monitor and improve the quality and safety of the service provided.”
criticalStaff competency: “The provider did not have safe recruitment and selection practices at the service. They had failed to follow their own policies by not obtaining all required recruitment information.”
criticalMedication management: “Staff had also not been assessed as being competent to support people with their medicines.”
criticalStaff training: “The registered person did not ensure all staff were competent, skilled and had up to date training in order to carry out their role and effectively support people and keep them safe.”
criticalCare planning: “People's care plans and risk assessments lacked detailed step by step guidance that showed any risks were understood and managed safely”
criticalPerson-centred care: “The registered person did not ensure people's care was always appropriate and met their needs and preferences.”
moderateSupervision / appraisal: “we found only one record of one care staff having had a one to one supervision meeting with the registered manager.”
moderateIncident learning: “There was not an effective system in place that the provider could evidence how they learned lessons when things go wrong.”
moderateComplaints handling: “this complaint had not been recorded, so the provider was not able to show their complaints procedure had been followed”
moderateConsent / capacity: “The provider had not ensured staff had received training about the MCA.”
moderateCommunication with families: “this person's and other people's care records contained no information about their communication and any sensory needs.”
moderateSafeguarding: “Two staff records did not show that the staff had completed safeguarding adults training.”
moderateRecord keeping: “Two people's assessments records had not been dated nor fully completed, lacked detail about people's needs and it was not always clear as to who had carried out the assessments.”

Strengths

· Relatives reported satisfaction with care and good staff timekeeping ('was flexible, they are willing to change the times and they [staff] come on time').
· Staff wore PPE in line with government guidance and left people's homes clean and tidy.
· Staff verbally demonstrated understanding of safeguarding and how to recognise/report potential abuse.
· People were supported to eat and drink enough to meet nutritional needs.
· Staff encouraged people's independence and supported them to attend healthcare appointments and exercise.

Quality-Statement breakdown (20)

safe: Staffing and recruitmentNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot 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 experience

Mathalie Care Services Limited

Inspection reports (3)