Bosworth Homecare received an overall rating of Requires Improvement following a focused inspection of Safe (rated Inadequate) and Well-led (rated Requires Improvement), with Warning Notices issued for breaches of Regulation 12 (safe care and treatment) and Regulation 17 (good governance). Key failures included absent health-specific care plans and risk assessments, unsafe medicines practices, short call visits, ineffective safeguarding processes, and poor governance oversight in the absence of a registered manager.
Concerns (9)
criticalCare planning: “People did not have health specific risk assessments in place. For example, people with Diabetes and Parkinson's Disease did not have care plans and risk assessments.”
criticalMedication management: “Staff were leaving medicines out for staff to administer later in the day or the next day for one person. This meant there was a risk medicines could be given incorrectly.”
criticalMissed or late visits: “We pay for 30 minutes of care, neighbours have timed them [staff] and they've been there anything from 8 minutes to 20 minutes.”
criticalSafeguarding: “Records were not consistently in place to evidence safeguarding concerns were always investigated and reported accordingly.”
criticalGovernance: “Systems in place to monitor the service and quality of care people received was not consistently or reliably used.”
criticalRecord keeping: “Not all people had care plans or risk assessments for medicines. One person required time critical medicines for Parkinson's Disease, but there was limited guidance in place.”
moderateIncident learning: “The provider had failed to ensure lessons were learned when things had gone wrong. Records were not kept.”
moderateLeadership: “Staff had not been managed effectively while there was no registered manager. This meant people using the service experienced differences in how their care was provided.”
moderateStaffing levels: “The manager acknowledged there had been points when there were not enough staff to deliver safe care.”
Strengths
· Staff received comprehensive training that prepared them to carry out their roles.
· Staff were recruited safely with necessary DBS checks completed before starting work.
· Staff used PPE effectively in accordance with government guidance.
· Supervisions were being undertaken on a more frequent basis and staff felt supported.
· The acting manager was honest, transparent and understood the duty of candour.
Bosworth Homecare improved from Requires Improvement to Good following a Warning Notice follow-up inspection, with the provider successfully addressing previous breaches of Regulation 12 (safe care) and Regulation 17 (good governance). Minor issues around call timeliness and governance detail were identified but promptly acted upon by the registered manager.
Concerns (2)
minorGovernance: “Systems measured the quality of the care provided by the service. Some of these lacked detail about issues such as timeliness of call times.”
minorMissed or late visits: “A small number of calls had been untimely and some call times were not agreed at a specific time. This had not impacted on their health.”
Strengths
· Care plans and risk assessments were regularly reviewed with health-specific guidance in place for staff.
· Medicine administration was safe with an audit system and trained staff.
· Safe recruitment practices including character and criminal records checks were in place.
· People felt very safe and reported no missed calls; staff stayed the full duration of care calls.
· Staff consistently wore PPE and followed infection control measures including COVID-19 training.