This focused inspection of a Leeds domiciliary care agency rated both Safe and Well-Led as Good, maintaining the previous 2019 overall Good rating. Recommendations were made regarding 'when required' medication protocols, decision-specific mental capacity assessments, and safe recruitment practices, but no regulatory breaches were found.
Concerns (6)
moderateRecord keeping: “Pre-employment checks did not always include explanation of gaps in employment. The provider did not submit evidence of completed staff file audits.”
moderateConsent / capacity: “Staff carried out mental capacity assessments for all people using the service...The assessments were not decision specific.”
minor
Medication management
: “the provider did not have protocols in place that described when 'when required' medications should be administered.”
minorStaff competency: “managers carried out competency checks for medication administration and manual handling regularly, however we found not all records were available to view.”
minorStaff training: “The provider kept a comprehensive record of where training had been completed, however we found some staff refresher training was overdue.”
minorMissed or late visits: “People told us staff were sometimes late to their visits. When this happened staff kept people informed.”
Strengths
· People felt safe and reported kind, compassionate care from staff who respected their privacy and dignity.
· Care plans were detailed, person-centred, and captured people's individual history; monthly audits were conducted.
· Effective safeguarding systems and policies in place; staff confident in raising concerns.
· Positive open culture with approachable management; staff felt supported.
· Provider worked in partnership with external stakeholders including local authority commissioners and care managers.