Age UK Stafford & District, a domiciliary care agency supporting 19 people, was rated Requires Improvement overall at its March 2019 inspection, having declined from Good in 2016. Key failures included unsafe medicines management, absent Mental Capacity Act documentation, and ineffective governance audits that failed to identify these shortfalls; care and responsiveness remained Good with staff treating people with dignity and delivering personalised support.
Concerns (8)
criticalSafeguarding: “During the inspection a safeguarding was raised, as the inspector identified potential abuse could be occurring.”
moderateMedication management: “There were no written protocols in place...no guidance for staff to follow in relation to when and where these creams should be administered.”
moderateMedication management: “Medication administration records (MARs) were not fully completed...it was not recorded if it had been offered to the person and if the person had taken it.”
moderateConsent / capacity: “There was no documentation in place to record capacity assessments and best interest decisions.”
moderateConsent / capacity: “Staff told us they had received training in the MCA, they could give us little detail on what this meant to them and how it applied to people.”
moderateGovernance: “Audits took place, they failed to pick up areas for improvement...systems had not identified that the management of medicines required strengthening.”
moderateGovernance: “The safeguarding policy used by the provider was not based upon the most recent local interagency policy.”
minorIncident learning: “The provider informed us that there had been no incidents or accidents since the last inspection nor had there been any complaints, so there were no lessons that had been learned.”
Strengths
· People felt safe and staff were safely recruited with DBS checks in place.
· Sufficient staffing levels with staff arriving on time and having adequate travel time.
· People were treated with dignity, respect and compassion; care rated Good.
· Personalised care plans reflected people's preferences, hobbies and cultural needs.
· People were supported to access healthcare services and appropriate referrals were made.
Quality-Statement breakdown (22)
safe: Using medicines safelyRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standardsGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
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 meet people's needs, preferences, interests and give them choice and controlGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Planning and promoting person-centred, high-quality care and opennessRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careRequires improvement
well-led: Working in partnership with othersRequires improvement
Age UK Stafford & District Care Services received a Good rating across all five key questions at its September 2016 inspection, with 37 people receiving personalised, safe, and dignified care in their own homes. The service demonstrated robust safeguarding, medicines management, staff support, and quality monitoring with no concerns identified.
Strengths
· People felt safe and trusted staff, with safeguarding concerns reported appropriately to local authority
· Risk assessments were thorough and acted upon, including identifying fall risks and delaying unsafe requests
· Medicines were managed safely with weekly audits of medication administration records by the manager
· Staff were consistently on time and people received advance weekly rotas of attending staff
· Staff received regular training, supervision, spot checks, and annual appraisals