New Concept Care Selby, a domiciliary care agency supporting 89 people, was rated Requires Improvement overall, with shortfalls in topical medicines management, risk assessments, late calls, Mental Capacity Act application and governance audits. Caring and responsive domains were rated Good, with people praising kind, person-centred staff and an open, supportive management culture.
Concerns (11)
moderate
Medication management
: “two people's creams had been applied more frequently than recommended and topical products were not always dated when opened”
moderateCare planning: “we found one person had no risk assessment for choking despite carers telling us they struggled to eat some foods”
moderateMissed or late visits: “Staffing levels were sufficient to meet people's needs, however sometimes staff were late to attend calls.”
moderateStaffing levels: “we saw staff rotas were produced with no, or little, travel time between calls and we saw errors were sometimes made on the rotas requiring staff to be at two calls at the same time”
moderateConsent / capacity: “mental capacity assessments did not detail what people could and could not do, and for some people there was no clarification on whether they could consent to care”
moderateConsent / capacity: “We asked the registered manager for details of Lasting Power of Attorney (LPA)... however there were no court records in people's files.”
moderateConsent / capacity: “best interest meetings had not always taken place when necessary... We found least restrictive options for care had not been recorded.”
moderateGovernance: “We found audits did not always identify issues... when issues were identified they were not always followed up.”
minorGovernance: “people said they had never seen the collated results of surveys or questionnaires”
minorGovernance: “We looked at a selection of policies and procedures. We found some were not up-to-date and did not reflect best practice.”
minorRecord keeping: “some records required updating to reflect people's recent change in needs”
Strengths
· People told us they felt safe in the care of the staff and were protected from abuse by trained staff
· Staff were recruited safely with DBS checks and two written references
· Thorough induction linked to the Care Certificate with regular ongoing training, supervision, appraisal and spot checks
· Caring, kind staff who respected privacy, dignity and confidentiality
· Person-centred, responsive care that supported independence and community access
Quality-Statement breakdown (11)
safe: People received their oral medications as prescribed, although more care was needed with the application of topical creams.Requires improvement
safe: Some people required further risk assessments to keep them safe.Requires improvement
safe: Staff were recruited safely and in sufficient numbers but sometimes late to calls; rotas did not support timely visits.Requires improvement
effective: Mental capacity legislation not always applied consistently; LPA records absent and best interest meetings not always held.Requires improvement
effective: Staff received induction, training, supervision and appraisal and supported nutritional and health needs.Good
caring: People were supported by staff who understood their individual needs and were encouraged to be independent.Good
responsive: Care records were person-centred although some required updating to reflect recent changes in needs.Good
responsive: Concerns and complaints were addressed appropriately.Good
well-led: Audits did not always identify issues and identified issues were not always followed up.Requires improvement
well-led: People were asked for opinions but had not seen the collated results of surveys.Requires improvement
well-led: Policies and procedures were not always up-to-date and did not always reflect best practice.Requires improvement