Moonlight Homecare Ltd is a domiciliary care agency providing personal care and support to people in their own homes in the London Borough of Ealing. At the time of the inspection the agency was supporting 3 older people. We carried out an assessment on 7 May 2024. The provider had developed care plans for each person, but these did not always contain information on the support the person required, and they would like that care provided. Our assessment was undertaken on 7 May 2024, and we gave the provider a short period of notice of the assessment to ensure someone was in the office. Following the assessment, we contacted a friend of one of the people receiving support for feedback. We received written feedback from 3 care workers following the assessment. During the assessment we reviewed the care plans and risk assessments of the 3 people receiving support and other documents related to the provision of care and the running of the service.
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Moonlight Homecare Ltd received an overall Good rating on its first inspection, with strong person-centred care, safe staffing and positive feedback from people and relatives. The Well-led domain was rated Requires Improvement due to incomplete and insufficiently detailed care records and daily notes, prompting a recommendation to implement national guidance on record keeping.
Concerns (4)
moderateRecord keeping: “Some care records were not always consistently clear or detailed enough and there was therefore a risk that a new member of staff reading those records would not know how to care for people appropriately.”
moderateCare planning: “Some people's care plans did not always provide appropriately detailed information about the personal care they required and which staff were actually providing.”
moderateGovernance: “These had not always ensured that accurate, complete and up to date records of people's care arrangements were maintained at all times.”
minorMedication management: “Staff had completed medicines support training and the registered manager was planning to assess their competency to provide this support safely.”
Strengths
· People and relatives spoke positively about staff, describing them as caring, respectful, honest and excellent.
· Sufficient staffing levels with no missed or late visits reported; people did not feel rushed.
· Robust recruitment processes including DBS checks and employment history verification.
· Staff received regular training, supervision and appraisals and felt well supported by the registered manager.
· Effective safeguarding systems in place; staff knew how to recognise and respond to abuse concerns.
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
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: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Continuous learning and improving care; duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood