critical“Medicines were not safely monitored and managed in line with national guidance. Appropriate records were not being kept. Care plans did not include a list of medicines prescribed.”
care planning
1 finding
critical“Care plans did not always provide staff with the necessary information to provide person centred care. This was a breach Regulation 9 (Person centred care).”
governance
1 finding
critical“Systems were either not in place or robust enough to demonstrate that there was adequate oversight of the service. This was a breach of regulation 17 (Good Governance).”
missed or late visits
1 finding
moderate“People and relatives told us care visits were often late and people were not kept updated when delays occurred. A relative said, 'Visits not on time and then we have an overlap.'”
person centred care
1 finding
moderate“People's care plans lacked personalised information about their life history, preferences and choices. People and their relatives told us they had not seen or been involved in writing their care plan.”
staff competency
1 finding
moderate“People and relatives told us staff lacked some of the necessary skills and knowledge. A relative said, 'They try their best probably but just haven't been trained, they have no idea.'”
supervision appraisal
1 finding
moderate“Staff induction records including sessions shadowing another member of staff and spot checks completed by a supervisor were mostly unavailable when we visited the providers office.”
record keeping
1 finding
moderate“Staff induction records were mostly unavailable. Medicines records were not being kept. Staff meetings were not always recorded.”
infection control
1 finding
moderate“People and their relatives told us PPE was not always used appropriately. A person said, 'PPE very random, no aprons, gloves, sometimes mask.' Another person said, 'No PPE worn.'”
complaints handling
1 finding
minor“During the inspection we became aware of a complaint which had not been recorded in line with procedure.”
communication with families
1 finding
minor“Some people and their relatives told us communication with the service was not effective. A person said, 'Major issues with the telephone contact numbers.'”