Complex Intervention Service, a reablement-focused domiciliary care agency in Southend-on-Sea, was rated Good overall at its April 2023 inspection, down from Outstanding in 2019. Key improvement areas included unpredictable call times, incomplete risk assessments (notably for catheter care), and insufficiently person-centred care plans, though safeguarding, medication management, staff support, and multi-agency working were all found to be strong.
Concerns (6)
moderate
Care planning
: “improvements were required to ensure information recorded within people's support plan was more detailed and person-centred.”
moderateMissed or late visits: “"This morning it was 10.10am and I am left thinking are they [staff] going to come or not? Some mornings it can be 7.00am, I don't like there are no set times"”
moderateRecord keeping: “Where people had a catheter in place, the risks associated with the catheter had not been considered or recorded.”
minorCare planning: “Staff told us they did not always have sight of a person's care plan prior to them visiting the person's home for the first time.”
minorMedication management: “improvements were required to ensure where people were prescribed a medicine to be given 30 to 60 minutes before food and all other medicines, this was completed in line with the prescriber's instructions.”
minorRecord keeping: “Improvements were required to ensure the reason for leaving employment was recorded.”
Strengths
· People felt safe and reported no concerns about their safety, with consistently positive feedback about staff attitude and care.
· Robust safeguarding arrangements with low incidence of concerns and prompt escalation when raised.
· Strong staff recruitment and retention practices with thorough DBS and pre-employment checks.
· Staff felt valued and supported by the registered manager, with effective induction and Care Certificate completion.
· Good multi-agency working with physiotherapists, occupational therapists, GPs, pharmacies and District Nurses.
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
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
effective: Ensuring consent to care and treatment in line with law and guidanceGood
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
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood