Tameside, a domiciliary care agency serving 11 people, received an overall Good rating at its first CQC inspection in November 2022. Key areas for improvement included gaps in pre-employment recruitment checks, limited staff knowledge of safeguarding and the Mental Capacity Act, and unassessed environmental risks, though the provider took prompt remedial action following the inspection.
Concerns (7)
moderate
Staff competency
: “Not all staff we spoke with had a good understanding of safeguarding or signs of abuse.”
moderateSafeguarding: “we found managers and staff knowledge relating to the MCA was very limited.”
moderateRecord keeping: “All required checks had not been completed prior to staff starting to work at the service.”
moderateGovernance: “systems had not identified the issues found during our inspection including recruitment checks, environmental risk assessments and staff knowledge of safeguarding and MCA.”
minorRecord keeping: “Two recruitment files identified gaps in previous employment, but there was no written explanation for the gaps.”
minorCare planning: “The initial assessment identified they did not have capacity...This information had not yet been transferred into the care records and risk assessments.”
minorMedication management: “some records appeared not to have details of the exact dosage that had been given.”
Strengths
· People told us they felt safe with staff and no visits had been missed; staff communicated proactively about lateness.
· Staff were described as friendly, kind, compassionate and hard working, with people's individuality and dignity respected.
· Detailed care records and person-centred risk assessments were in place to guide staff effectively.
· Thorough induction process including 3-day shadowing and regular competency spot checks by the registered manager.
· People and relatives were positive about the approachability and professionalism of the registered manager and nominated individual.
Quality-Statement breakdown (19)
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safely; Learning lessons when things go wrongGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
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 careGood
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
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
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 staffGood
well-led: How the provider understands and acts on the duty of candour; Continuous learning and improving careGood