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

Inspection report · 2023-04-19

Framework: KLOE · 17 pages · 95 KB · PDF

Requires improvement

safe: Requires improvementeffective: Requires improvementcaring: Goodresponsive: Goodwell-led: Requires improvement

UK Case Management Limited, a domiciliary care agency in North Yorkshire, received an overall rating of Requires Improvement at its first inspection, with breaches of Regulations 12, 13 and 17 identified relating to unsafe medication management, inadequate safeguarding escalation and ineffective governance systems. The service demonstrated genuine strengths in its caring culture, low staff turnover, person-centred practice and community engagement, but must address significant gaps in risk assessment, care planning records and quality oversight.

Concerns (7)

criticalMedication management: “Medication administration records had missing signatures for administration, prescribers' instructions were not always included and medications which required a variable dose had not been recorded.”
criticalSafeguarding: “We identified a safeguarding concern and found there had been a delay in escalating safeguarding concerns which increased the risk of harm to a person.”
criticalGovernance: “Audits that were in place had been ineffective in highlighting the concerns raised at this inspection. For example, care plan audits did not highlight missing information or risk assessments.”
criticalRecord keeping: “The provider failed to maintain accurate, complete and contemporaneous records.”
moderateCare planning: “Care plans did not always include guidance on all aspects of people's care needs to ensure support workers were aware of how to provide support safely.”
moderateStaff competency: “Competency in certain care areas had not been assessed or recorded by the provider.”
moderateIncident learning: “Systems to monitor the welfare of the people were not robust causing delays in concerns being escalated and addressed.”

Strengths

· Staff turnover was very low, supporting people to receive consistent care from staff who knew them well.
· Safe recruitment practices were in place with appropriate checks for new staff.
· People were supported to have maximum choice and control of their lives in the least restrictive way possible.
· The service had built up strong relationships with other healthcare professionals and referrals were sent without delay.
· People and relatives gave very positive feedback about the caring nature of support workers.

Quality-Statement breakdown (21)

safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongRequires improvement
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced diet

Inspection reports (2)