Midas Care Solutions Ltd was rated Requires Improvement overall at its June 2023 inspection, with breaches of Regulation 11 (consent/MCA) and Regulation 17 (good governance) identified. While staff were knowledgeable, caring and safely recruited, persistent failures in care plan detail, MCA documentation and ineffective auditing meant risks to people were not consistently identified or mitigated.
Concerns (6)
criticalConsent / capacity: “MCA assessments had been completed but they were not decision specific and there were no documented best interest decisions.”
critical
Governance
: “Governance arrangements were not effective in identifying areas of improvement. Audits were not identifying concerns and driving improvements in medicines administration.”
moderateMedication management: “Medicines were not consistently recorded in people's medicines administration records. For example, where people were having a topical cream applied this had not been documented as a medicine.”
moderateCare planning: “Risk assessments were not clearly documented. Where initial assessments had identified people were at risk guidance was either not in place or limited for staff.”
moderateRecord keeping: “There was no care plan audit in place, this meant where care plans were missing or lacked details this had not been identified.”
moderateCare planning: “One person had needs relating to their diabetes. This was identified in the assessment but there was no guidance in the care plan for staff.”
Strengths
· Staff understood how to recognise abuse and report concerns; people and relatives felt safe using the service.
· Staff were safely recruited using Disclosure and Barring Service checks.
· Staff received induction, training and competency assessments including safeguarding, manual handling and dementia.
· Infection prevention and control measures were in place and regularly checked.
· People were supported by a consistent staff team and told inspectors staff were kind, compassionate and experienced.
Quality-Statement breakdown (17)
safe: Using medicines safelyRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentRequires improvement
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietRequires improvement
effective: Supporting people to live healthier lives, access healthcare services and supportRequires improvement
effective: Staff support: induction, training, skills and experienceGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service; continuous learning and improving careGood