Glossop DCC Homecare Service was rated Requires Improvement overall following a January 2019 inspection, with two regulatory breaches identified: unsafe medicines management (Regulation 12) and ineffective governance and quality assurance (Regulation 17). The service demonstrated strengths in caring, responsiveness and staff skills, but inconsistent staffing continuity and failed medication audit systems posed risks to the 104 people receiving care.
Concerns (6)
criticalMedication management — “Staff had failed to sign both MARS we looked at on several occasions dating back to November 2018.”
criticalStaff competency — “Staff working at the service had not had their competence to administer medicines assessed to ensure they were administering medicines safely.”
criticalGovernance — “This system had failed to identify recording errors on the medicines administration recording sheets we found and reported on in the safe question.”
moderateStaffing levels — “We are a bit short staffed now which has caused some inconsistencies, it's not bad overall but more staff would help.”
moderatePerson-centred care — “Staffing was not always provided to people in line with their preferences due to organisational changes taking place.”
moderateRecord keeping — “Prior to that, accurate records were not made available to us in relation to the regulated activity.”
Strengths
· People and families provided overwhelmingly positive feedback about staff attitudes and care quality.
· Effective safeguarding systems in place with staff demonstrating good understanding of safeguarding responsibilities.
· Staff training, supervision and support was in place including induction and the Care Certificate.
· Care plans were personalised and regularly reviewed with involvement from people and relatives.
· The service worked positively in partnership with external health professionals including community paramedic team.
Quality-Statement breakdown (23)
safe: Using medicines safelyRequires improvement
safe: Staffing levels and continuityRequires improvement
safe: Systems and processes / safeguardingGood
safe: Assessing risk, safety monitoring and managementGood
DCC High Peak Home Care, a domiciliary care agency supporting 92 people, improved its overall rating from requires improvement to Good at this focused inspection and exited Special Measures. Sufficient improvements in governance meant the provider was no longer in breach of Regulation 17, with safe, responsive and well-led all rated Good.
Strengths
· Staff trained in safeguarding and aware of responsibilities to protect people from avoidable harm
· Personalised care plans with person-centred information; people felt involved in care planning
· Call monitoring and scheduling system in place to alert to late/missed calls; people received calls on time
· Sufficient staffing with regular, suitably qualified staff; safe recruitment procedures including DBS and references
· Medicines safely managed in line with national best practice; staff competency assessments and MAR audits
Quality-Statement breakdown (15)
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
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood