critical“There were 567 calls in January more than 45 minutes late. This represented 50% of the total number of calls.”
critical“22% of calls in January were less than half the allocated time required to meet people's needs.”
critical“Of the 19 visit schedules we reviewed the first visit on 10 of the schedules was over 50 minutes late. The visit schedules also didn't have sufficient travel time between visits.”
critical“Yesterday I had to phone the office because [staff] didn't come. I had to make sure I got my medicines.”
critical“21 had concerns about the time and duration of calls...30 to 45 minutes calls were completed in less than 15 minutes...2 to 3 hours late, which has an impact as I take my medication in the morning.”
moderate
“Half of the agency carers don't stay very long, they are miserable, and the timings are no good.”
governance
4 findings
critical“The quality assurance system was not robust. This was a continued breach of regulation 17 of the Health and Social Care Act 2008.”
critical“The provider had failed to ensure effective governance systems were in place to ensure the continual improvement of services provided to people and compliance with regulations.”
critical“There had been no effective system for auditing in place...Governance processes did not identify shortfalls found during the inspection.”
critical“The quality assurance system was not robust. This placed people at risk of harm and was a continued breach of regulation 17(1)”
medication management
4 findings
moderate“For 1 person who received Paracetamol, we found the time interval between doses being given were too close together.”
critical“Medicines were not managed safely. We found continued concerns in relation to the administration and reconciliation of medicines. The service has a history of noncompliance with medicines and has been in breach of regulations on 8 occasions.”
critical“For 2 people who received when required Paracetamol, we found the time interval between doses were given too close together.”
critical“Medicines were not managed safely. Good practice guidance was not followed and effective systems were not in place to ensure medicines were given as prescribed and accurate records were made.”
care planning
4 findings
moderate“When I get staff who don't know me, I have to tell them what I need doing, there's a care plan, surely they have it, but they don't look.”
critical“Approximately 100 care plans were out of date. These were planned to be reviewed annually or if there were any changes in people's support needs.”
critical“half of the care plans we saw had not been reviewed within this timescale.”
moderate“Clear guidance was not always in place for any specific support required.”
record keeping
3 findings
moderate“The electronic medicines records were not updated in a timely manner to reflect the most current medicines that needed to be administered to people.”
moderate“Records about medicines were not always accurate and could not show that people were given their medicines as prescribed because some staff did not have access to the new electronic system.”
moderate“the information they were able to access via their work phones about people's risks and support needs was 'basic' and was not always updated”
leadership
2 findings
moderate“At the time of our inspection there was not a registered manager in post. They had recently left, and a new manager has been recruited.”
critical“The service had not been well led. Management arrangements and quality assurance systems had not been effective since the last inspection.”
staff competency
2 findings
critical“Appropriate medicine competency assessments had not been completed. We could not be assured staff had the necessary skills and knowledge to give medicines safely.”
critical“Some care staff who administered medicines had not had their competency assessed to ensure they had the necessary skills and knowledge to give the medicines support.”
incident learning
2 findings
moderate“Although some medicines audits were completed, the errors we found during the inspection had not been identified.”
critical“When families raised concerns the previous manager would brush issues under the carpet. Including issues related to short or late visits or poor care.”
staffing levels
2 findings
moderate“There was a high use of agency staff. People told us agency staff did not know people's needs...agency staff who have no idea who I am or what to do for me.”
moderate“Premier Homecare had struggled to recruit to the office-based co-ordinator and supervisor roles and had carried vacancies in these areas for several months.”
supervision appraisal
2 findings
moderate“No spot checks made, although 1 staff had had a spot check after your visit, the 2nd one in 5 years.”
moderate“staff spot checks / observations and supervision meetings not being completed.”
safeguarding
1 finding
critical“We could not be assured these had always been reported to the local authority safeguarding team or to the Care Quality Commission.”
staff training
1 finding
moderate“Refresher training for staff was out of date and many staff had not received refresher training for over 2 years according to the training matrix provided.”
person centred care
1 finding
moderate“Some agency staff turn up and don't know anything about her and mum gets confused with this.”
infection control
1 finding
minor“one person's assessment stated there were no risks associated with infection control, but staff needed to clean the commode and so were dealing with bodily fluids.”