FDR Social Care Ltd is a domiciliary care agency registered to provide personal care. At the time of the assessment, one person was receiving support with personal care from the service. The assessment was carried out remotely between 23 August 2024 and 7 October 2024. The assessment was carried out as the service was rated Inadequate at the last inspection published in May 2023. This assessment was to assess whether improvements had been made to the service and whether the breaches of regulations identified at the last inspection had been sufficiently addressed. All quality statements were looked at during the assessment. It was carried out under a pilot methodology where evidence gathered, and reporting was done under one evidence category per quality statement. We found two breaches of the legal regulations in relation to Safe Care and Treatment and Good Governance. We have asked the provider for an action plan in response to the concerns found at this assessment. The service was no longer in breach of regulations regarding Dignity and Respect, Person-Centred Care, Safeguarding service users from abuse and improper treatment and Fit and Proper Persons Employed. There was inconsistent information across different formats of care plans and changes identified in reviews had not been reflected in all the documents. Information about medications was not always accurate or risk assessed, and some risk assessments required improvements to ensure people were kept safe. The service’s auditing systems had failed to identify these shortfalls. Recruitment practices had improved and there was a system in place to identify, report and respond to safeguarding concerns. Improvements had been made in maintaining accurate records and dignity and privacy had been maintained. Care workers ensured people received care tailored to their needs.
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FDR Social Care, a small domiciliary care agency in Northampton, was rated Inadequate overall at its first inspection in March 2023, with breaches across six regulations including safeguarding, safe recruitment, care planning, dignity, person-centred care, and governance. The service was placed in special measures due to widespread failures in leadership oversight, record-keeping accuracy, and staff competency, particularly in meeting the needs of autistic people.
Concerns (13)
criticalSafeguarding: “The provider failed to have sufficient systems in place to protect people from abuse and improper treatment. This placed people at risk of harm.”
criticalStaffing levels: “There were not enough staff employed using safe recruitment practices to provide all the care people required to meet their needs.”
criticalStaff training: “Staff did not have the training or skills required to know how to manage people's specific needs such as Parkinson's disease, autism, and seizures.”
criticalGovernance: “The provider failed to assess, monitor and improve or mitigate known risks affecting the quality and safety of the service.”
criticalRecord keeping: “The provider failed to keep accurate records of people's daily care, rotas, staff employment information, induction, supervision and training records.”
criticalCare planning: “People's care plans were not always reflective of people's current needs. Where people's needs had changed, the provider had not always assessed the risk.”
criticalIncident learning: “The provider did not use their systems to record accidents, incidents, safeguarding concerns or complaints. This meant they did not have the information they required to analyse and learn.”
criticalMedication management: “The medicines audit completed in March 2023 showed medicine records had been reviewed...however, there were no people receiving medicines from staff; the audit was fictitious.”
criticalLeadership: “There was very poor managerial oversight of safeguarding, incidents, complaints, people's records, rotas, staff records and audits.”
criticalStaff competency: “Staff had received safeguarding training but there was no evidence their competency had been checked. Staff failed to do so in practice.”
moderateSupervision / appraisal: “The provider's records for supervisions were not accurate. For one member of staff the supervision dates did not correlate with the dates of employment.”
moderatePerson-centred care: “The negative culture within the service meant the provider failed to provide respectful and dignified care to autistic people.”
moderateComplaints handling: “The provider failed to maintain a log of the complaints they had received or the actions they had taken.”
Strengths
· People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
· Staff understood people's rights to refuse care and recorded consent at every visit before providing care.
· People and their relatives had been involved in the assessment process, including consideration of protected characteristics under the Equality Act 2010.
· People's environmental risks were assessed and steps taken to mitigate these risks.
· Staff received training in infection prevention and control and used PPE appropriately.
Quality-Statement breakdown (17)
safe: Staffing and recruitmentInadequate
safe: Systems and processes to safeguard people from the risk of abuseInadequate
safe: Assessing risk, safety monitoring and management; Using medicines safelyInadequate
safe: Learning lessons when things go wrongInadequate
safe: Preventing and controlling infectionGood
effective: Staff support: induction, training, skills and experienceInadequate
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Respecting and promoting people's privacy, dignity and independenceRequires improvement
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesRequires improvement
responsive: Improving care quality in response to complaints or concernsRequires improvement
responsive: Meeting people's communication needsGood
responsive: End of life care and supportNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringInadequate
well-led: How the provider understands and acts on the duty of candourInadequate
well-led: Engaging and involving people using the service, the public and staff; Continuous learning and improving careInadequate