Conquest Care and Support Agency received an overall rating of Requires Improvement following a focused inspection in March 2023, with breaches of Regulations 12, 17, 18 and 19 identified across safe care and treatment, governance, staffing, and recruitment. Key failures included inadequate risk assessments, unsafe medicines management, persistent late care visits, and ineffective governance systems, resulting in two warning notices from CQC.
Concerns (9)
criticalCare planning: “The local authority assessment for a third person indicated they required a soft diet due to digestive problems, but this was not recorded in the provider's care plan.”
critical
Medication management
: “Medicines were not audited effectively to help ensure they were administered as prescribed... we saw discrepancies... 'no outcome recorded' but without a reason.”
criticalMissed or late visits: “They come 45 minutes to an hour late sometimes. The majority of the time they are late.”
criticalStaffing levels: “Care workers being recorded in two places at once contributed to this effect... care hours delivered were double the planned amount of care hours.”
criticalGovernance: “Systems were either not in place or robust enough to demonstrate service improvement was effectively managed. This was a repeated breach of Regulation 17.”
criticalStaff competency: “2 of the staff did not have work references or DBS checks back... One staff member did not have proof of their eligibility to work in the UK.”
moderateRecord keeping: “The provider could not tell us how many incidents there had been in the last 12 months, as there was no audit or overview of the incidents.”
moderateIncident learning: “It was not always clear from the records, how complaints and incidents were responded to, as lessons learnt were not written down to help improve service delivery.”
moderateConsent / capacity: “Two people's care plans had a sentence at the end of them which stated the care plan was agreed by both parties. However, only the Conquest Care representative had signed it.”
Strengths
· Staff were supported through induction, training and supervision, and knew how to respond to safeguarding concerns.
· Care workers wore PPE and followed good hygiene practices, with people confirming they felt safe from infection risks.
· People were involved in care planning and made choices about how they wished to receive their care.
· The provider worked in partnership with local authority and other health and social care professionals.
· People's diverse needs such as culture, religion and language were considered as part of the assessment process.
Quality-Statement breakdown (17)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
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
well-led: Continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Engaging and involving people using the service, the public and staffGood