Veraty Care Solutions Ltd was rated Requires Improvement overall following a focused inspection that identified unsafe medicines management with unexplained MAR gaps and no audits for over six months. A breach of Regulation 17 (Good governance) was identified due to limited and unembedded quality monitoring systems and inconsistent managerial oversight.
Concerns (10)
criticalMedication management: “Medicine administration records (MAR) did not state the full medication name or dosage and had not been signed at the beginning of the medication cycle to confirm stock levels received.”
criticalMedication management: “MARs had not been audited by the provider for over 6 months. This meant the provider did not have oversight of people's medication”
critical
Governance
: “Poor oversight meant risks to people's care and support were not always sufficiently monitored and placed people at the potential risk of harm”
criticalGovernance: “The systems in place were not embedded into the service, with many audits either not being completed or documented fully. People's daily records were not being checked.”
moderateRecord keeping: “Multiple gaps in recording on MARs were observed... correct codes were not being used to explain why medications had not been administered.”
moderateLeadership: “The registered manager did not have consistent oversight of the service.”
moderateSafeguarding: “Safeguarding incidents had been reported to the local safeguarding team; however, these had not always been sent to the CQC in a timely way as required.”
moderateIncident learning: “consistent analysis wasn't being undertaken to learn from these when things had gone wrong.”
minorCare planning: “Some care plans had not been reviewed or audited since they were implemented”
minorStaffing levels: “we are struggling to get staff and due to some of our clients living in rural areas it makes it difficult to recruit.”
Strengths
· People reported feeling safe with staff supporting them
· Staff knew how to recognise signs of abuse and how to report issues
· Safe recruitment practices including DBS checks and references
· Adequate PPE provision and infection control in line with COVID-19 guidance
· Care plans and risk assessments contained enough guidance for staff
Quality-Statement breakdown (8)
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuse; Learning lessons when things go wrongRequires improvement
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; promoting a positive culture; continuous learning and improving careRequires improvement
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staff; working in partnership with othersGood
Veraty Care Solutions Ltd, a domiciliary care agency supporting 22 people, was rated Good across all five key questions, having improved from a previous Requires improvement rating by addressing quality assurance concerns. The service delivered safe, person-centred care with well-trained staff, effective partnership working, and robust governance systems.
Strengths
· Staff were caring, compassionate and treated people with dignity and respect
· Person centred care based on individual needs and preferences
· Safe recruitment processes with thorough pre-employment checks
· Sufficient staffing with consistent allocation of the same care workers
· Robust induction, training, supervision and appraisal systems for staff
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
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