Nomase Care Ltd improved from Requires Improvement to Good overall, clearing previous breaches in risk management, medicines, consent, governance and notifications. However, well-led remained Requires Improvement due to persistent issues with electronic call monitoring showing overlapping visits and inaccurate staff log-in/out, meaning visit timeliness and duration could not be assured.
Concerns (5)
moderateMissed or late visits: “We found staff were scheduled to be in two places at the same time and/or did not have sufficient travel time between visits to enable them to get to people on time.”
moderate
Record keeping
: “The ECM data showed staff were routinely logging into one visit before logging out of the previous visit.”
moderateGovernance: “the issues with staff logging in and out incorrectly persisted which meant the provider could not demonstrate all people were getting their care visits as planned.”
moderateMissed or late visits: “They get everything done but I never know when they are coming, and they don't stay for the full time and They only stay about 15 minutes instead of 30.”
minorMedication management: “the provider was not aware of national initiatives such as STOMP which is a project to stop the over medication of people with a learning disability, autism or both with psychotropic medicines.”
Strengths
· Improvements made to risk assessments including person-centred fire risk assessments and referrals to London Fire Brigade
· Safe medicines management with correctly completed MARs and competent, trained staff
· Safer recruitment processes including DBS, references and right-to-work checks
· Staff understood safeguarding and whistleblowing procedures and how to escalate concerns
· MCA principles followed; capacity assessments and best interests decisions completed appropriately
Quality-Statement breakdown (10)
safe: Assessing risk, safety monitoring and managementGood
safe: Preventing and controlling infectionGood
safe: Using medicines safelyGood
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careRequires improvement
well-led: Planning and promoting person-centred, high-quality care and support with openness; and 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