Medacs Healthcare PLC received a 'Requires Improvement' rating (down from 'Good') following a focused inspection of Safe and Well-led domains, with key failures in care plan currency, medicines documentation, staff induction oversight, and governance audit coverage. Strengths included safe recruitment practices, effective safeguarding collaboration, robust root cause analysis processes, and positive feedback from people about staff conduct.
Concerns (8)
moderateCare planning: “Some care plans had not been updated or reviewed for more than one year. This meant there was not always evidence to demonstrate risks to people's health and safety were being effectively assessed.”
moderateRecord keeping: “Care files held in the office were not always easy to navigate with archived records mixed with current records... the system did not contain care plans or risk assessments.”
moderateMedication management: “Protocols for administering as needed medicines were not always in place. Some care records on the providers electronic care records system did not always record people's GP and/or pharmacist.”
moderateStaff training: “Periods of shadowing for staff new to care were often short and records did not always evidence any follow up with the member of staff to make sure they felt confident in their role.”
moderateGovernance: “Systems to audit quality and safety within the service at branch and provider level were in place but needed some improvement to make sure they covered all aspects of the service.”
minorPerson-centred care: “One person said they did not know if their care plan had changed when their needs changed. Another said an admin person visited and left a care plan which was supposed to have been updated but never got updated.”
minorMissed or late visits: “One person we spoke with said there had been a missed call. Some people commented calls were not always on time and this has meant calls had been very close together.”
minorSafeguarding: “Safeguarding incidents had been investigated appropriately and followed up. However, documentation in relation to these incidents had not always been signed by the registered manager.”
Strengths
· Staff were recruited safely and the registered manager took immediate action to address induction issues identified during inspection.
· Staff knew what to do if they thought someone was at risk and safeguarding referrals were made appropriately; local authority safeguarding team confirmed the service worked well with them.
· Where issues were identified, root cause analyses were completed and lessons learned to prevent recurrence.
· People felt safe with staff and were complimentary of the care received; staff felt well supported by management.
· The service was working within the principles of the Mental Capacity Act 2005.
Quality-Statement breakdown (9)
safe: Staffing and recruitmentRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
well-led: Promoting a positive culture; engaging and involving people; working in partnershipRequires improvement
well-led: Managers and staff being clear about roles; understanding quality, performance, risks and regulatory requirements; continuous learningRequires improvement
well-led: Duty of candour; being open and honest when things go wrongGood