Weston Business Centre, a domiciliary care service supporting people with learning disabilities and autism, was rated Good overall following a November 2022 inspection. While care quality and leadership were positive, recruitment gaps and absence of medication competency assessments prompted a recommendation to review recruitment practices.
Concerns (3)
moderateStaff competency: “there was no evidence to demonstrate staff had had their competency assessed to ensure they were skilled to undertake this task safely.”
moderateRecord keeping: “there was no evidence of a second reference having been received for three out of four members of staff.”
moderate
Safeguarding
: “The DBS certificate for one member of staff was received 17 days after they commenced in post. There was no evidence of a completed Adult First Check or risk assessment.”
Strengths
· People and relatives reported feeling safe and expressed confidence in the staff team.
· Staff supported people with choice, control and independence, focusing on strengths and positive risk-taking.
· Consistent staffing ensured people received care from a regular core team who understood their needs.
· No missed calls reported; staff communicated promptly when running late.
· Relatives and staff were complimentary about the registered manager and overall service quality.
Weston Business Centre improved from Requires Improvement to Good overall following resolution of a prior staffing breach and absence of a registered manager, with all five key questions rated Good at this inspection. The service demonstrated safe staffing levels, robust medicines management, person-centred care planning, and effective governance systems.
Strengths
· Staffing levels restored to meet contracted hours following previous breach of Regulation 18; new computerised rota system introduced to track travel times and ensure call punctuality
· Safe recruitment procedures in place including DBS checks, references, application forms and interviews
· Staff received safeguarding training and understood whistleblowing responsibilities
· Medicines administered as prescribed with competency assessments, protocols for PRN medicines and regular audits
· Mental Capacity Act principles applied consistently; capacity assessments and best interest decisions documented
Mashdel Services received an overall Requires Improvement rating at this announced inspection, with a breach of Regulation 18 found due to staff working excessive hours of up to 96+ hours on 24-hour care packages without adequate breaks or cover. While care delivery, training, safeguarding and personalisation were of a good standard, governance systems failed to detect unsafe staffing deployment and the service lacked a registered manager at the time of inspection.
Concerns (4)
criticalStaffing levels: “rotas identified staff working for 96 hour or more shifts... staff were not able to have a full period of sleep and were working unsafely and excessive hours with no breaks.”
moderateGovernance: “monitoring visits... failed to identify that staff allocated to 24 hour packages of care were working excessive hours with no breaks.”
moderateLeadership: “A registered manager was not in post at the time of inspection... formalised quality audit systems were not yet fully established and embedded within the service.”
minorPerson-centred care: “Another person who had a 24 hour care provision in place was also requesting a later time for going to bed and the service was unable to meet this request.”
Strengths
· People felt safe and staff demonstrated good understanding of safeguarding, including how to identify and report concerns.
· Medicines were managed safely with correctly completed MAR charts and written protocols in place.
· Staff were well trained with up-to-date mandatory training, regular supervisions and annual appraisals.
· Staff demonstrated good understanding of the Mental Capacity Act 2005 and obtained consent before providing care.
· Care plans were personalised, well-maintained and contained accurate information about people's needs and preferences.
Quality-Statement breakdown (16)
safe: Staffing levels and deploymentRequires improvement
safe: SafeguardingGood
safe: RecruitmentGood
safe: Risk managementGood
safe: Medicines managementGood
effective: Staff training and supervisionGood
effective: Mental Capacity Act and consentGood
effective: Nutrition and hydrationGood
caring: Dignity, respect and person-centred approach
Good
caring: Involvement in care decisionsGood
responsive: Care planning and personalisationGood
responsive: Complaints handlingGood
responsive: Feedback and engagementGood
well-led: Registered manager in postRequires improvement
well-led: Quality assurance and governance systemsRequires improvement