critical“The medicines care plans and risk assessments were generic and did not take account of people's individual needs and risks to their safety, such as their mental capacity, memory, any potential side effects”
care planning
1 finding
moderate“When people were diagnosed with specific healthcare conditions or had an additional need such as dementia, there were not always assessments to show how the risks relating to these could be managed.”
staff competency
1 finding
critical“The staff had not attended any face to face training arranged by the provider nor had their competencies and skills been assessed in certain areas, such as administering medicines and moving people safely.”
staff training
1 finding
moderate“The provider was not able to demonstrate they had checked this [staff training with other providers].”
governance
1 finding
critical“Records of these were not always complete and some information had been copied from one audit to another. In some cases, the information was not relevant to the person.”
record keeping
1 finding
moderate“The provider did not always maintain complete and accurate records for staff, including checks on their suitability and records of their training, supervision and support.”
staffing levels
1 finding
critical“The provider had not always obtained essential information about their past employment, skills and knowledge, references from previous employers or followed up on concerns identified during recruitment.”