Date of assessment 12 June to 21 August 2024. Clarendon Home Care is a domiciliary care agency providing personal care. The service provides support to people living in their own homes in the community. At the time of our inspection the service was providing personal care to 52 people. We undertook this assessment to follow up on concerns identified in the previous inspection. Safety concerns were reported, investigated and lessons were learned. The provider ensured safe continuity of care between services. The provider acted appropriately to minimise the risk of abuse. The provider involved people in the management of risks to their health and safety. The provider ensured there were enough suitably qualified staff to support people in a timely manner. Staff received adequate training, induction and ongoing supervision of their performance. The risk of infection was minimised and people’s medicines were appropriately managed. The provider promoted people’s independence and ensured their care choices were met. People’s care plans were written with people and their families and staff prioritised people’s choices for their care. The provider minimised the risk of inequality of people’s experiences in their care. The provider had a clear vision and values for the service and staff demonstrated a clear understanding of the structure and purpose of their roles. The service had capable and compassionate leaders. There were clear systems in place for monitoring the culture and morale of the service and staff and people using the service felt able to speak up when needed. The provider had effective governance systems in place to manage risks to people’s care. The provider worked collaboratively with external agencies and systems were in place for learning from incidents and improving the service. The provider valued diversity in its workforce.
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Focused inspection of Clarendon Home Care found a continued breach of Regulation 18 (Staffing), with late calls, insufficient travel time and an unreliable electronic call monitoring system. Despite improvements in oversight, safeguarding, medicines and governance audits, both Safe and Well-led remained Requires Improvement.
Concerns (5)
criticalStaffing levels: “the provider was in continued breach of Regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.”
moderateMissed or late visits: “Sometimes they are late by half an hour to one hour; Other carers are erratic and turn up an hour to two hours late”
moderateGovernance: “a new ECM not working as it should resulting in manual loggings and posing a risk of not identifying missed calls on time.”
moderateCare planning: “staff not having enough travel time between calls, insufficient time spent on some calls”
moderateLeadership: “the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.”
Strengths
· Staff knew how to identify and report abuse and were trained in safeguarding of vulnerable people.
· Risk assessments and management plans were in place which enabled staff to provide care safely.
· Safe recruitment checks were undertaken to ensure suitable staff were employed at the service.
· People received the support they needed to take their medicines safely.
· Staff knew how to minimise the risk of infection and had access to PPE.
Quality-Statement breakdown (11)
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Working in partnership with othersNot rated