critical“Staff did not have written guidance in place to follow when medicines were prescribed to be given "when required" or with a choice of dose.”
critical“There were no records of staff competency checks. This meant the provider could not be certain medicine procedures were being followed correctly and safely.”
care planning
1 finding
critical“The registered manager was unable to provide [pre-assessment forms]. This meant people were at risk of receiving care from staff who did not fully understand their health conditions.”
consent capacity
1 finding
critical
“Where a person lacked mental capacity, the provider had not taken steps to confirm whether their relative had the legal authority to make decisions for them.”
governance
1 finding
critical“Audits had not picked up significant shortfalls in practices in relation to medicines management, pre-admission form and confirming if the provider had seen the lasting power of attorney.”
record keeping
1 finding
moderate“Records of what had been audited were not routinely kept by the service. The provider had not adequately assessed, monitored and improved the quality and safety of the service.”
person centred care
1 finding
moderate“The provider also had not followed their own procedures and had not always ensured that prior to supporting people, their needs were comprehensively assessed.”