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Date of Assessment: 18 June to 15 July 2025. The service is a care at home service providing support to older people and people living with dementia. The provider was in breach of regulation in relation to safe care and treatment and the governance of the service. Risk assessments were not always in place when clinical needs had been identified which meant the provider could not be assured staff knew how to manage these risks. Documentation in people’s care files stored at their homes and in the office were inconsistent. Medicines were not always stored and administered safely. People’s Medicines Administration Records (MAR’s) showed unexplained gaps which had not been identified as the provider did not have effective audit systems in place. This meant the provider could not be assured medicines were administered safely. Staff were not always recruited safely. The provider accepted training completed by other employers which meant they could not be assured training provided was adequate. However, people and relatives told us staff were well trained and knowledgeable. Accidents and incidents were not always recorded formally or analysed to reduce the risk of reoccurrence. This meant safeguarding referrals had the potential to be missed by the provider. The safeguarding policy was out of date and had not been reviewed. However, staff assured us they knew how to raise safeguarding concerns. People told us they felt safe and relatives were confident people were safe. People and relatives told us staff knew them well and understood how to meet their needs safely. People’s needs were not always formally assessed at the start of the care package. People were not always aware of what care documentation was in place regarding them. However, where assessments had been completed, they were holistic and person centred. People were supported to have their health needs met and the provider worked effectively with other agencies, so people received the health input they needed. However, they did not always corroborate health information passed on by third parties in order to ensure the information was accurate. People were asked for consent before care was provided, and decisions were made in their best interests where appropriate. People were supported by staff who were kind and caring and knew them well. People were supported by staff who treated them with compassion and empathy and worked with them to promote their independence. People were supported by staff who respected their privacy and dignity. People were involved in their care and supported to make their own choices. People were asked for consent before care was provided to them. People were confident they could provide feedback and any concerns would be addressed. People were provided with responsive care that was flexible to meet their individual needs and respected their preferences. Systems were not in place to check the quality of the service which meant concerns were not always identified and action was not always taken to reduce the risk of reoccurrence. The provider was not always knowledgeable about their regulatory responsibilities. Oversight of the service was not always sufficient due to the lack of registered manager and clear managerial structure. However, people, relatives and staff told us they felt well supported by office staff and the provider. The provider disseminated a clear shared vision centred on people receiving care they would like their family to receive. Staff were clear about this vision and were motivated to deliver care in this way.
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