MADeBA Care Ltd (trading as Excalibur Serviced Offices) was rated Requires Improvement overall at its September 2017 inspection, with Good ratings for safe, caring and responsive but Requires Improvement for effective and well-led. Key failures centred on staff refresher training not being updated for over five years and governance systems failing to identify this shortfall or inconsistencies in care delivery documented in daily records.
Concerns (4)
moderateStaff training: “suitable refresher training had not been carried out for five years for these staff members and therefore they could not be assured of having current and up to date skills and knowledge”
moderateGovernance: “Systems in place had not identified shortfalls in some practices undertaken by members of staff and shortfalls in training requirements.”
moderateRecord keeping: “audits of records returned to the office were not sufficient to identify areas where clarification was needed”
moderateCare planning: “The care plan and other records at the office did not show this as an identified care need and did not provide any instructions on how staff needed to complete this.”
Strengths
· People and relatives confirmed they felt safe and praised staff as kind, friendly and respectful
· Consistent staffing arrangements meant people received care from familiar staff they knew well
· Risk assessments were in place covering equipment use, medicines, showering and dressing
· Staff demonstrated knowledge of safeguarding responsibilities and whistleblowing procedures
· Care plans were detailed and person-centred where a care need had been identified
Quality-Statement breakdown (18)
safe: Safeguarding and protection from abuseGood
safe: Risk assessmentsGood
safe: Staffing levels and consistencyGood
safe: Medicines managementGood
safe: Recruitment practicesGood
effective: Staff training and competencyRequires improvement
effective: Consent and Mental Capacity Act complianceGood
effective: Support with nutrition and healthcareGood
caring: Kindness and respect from staffGood
caring: Involvement in care and promotion of independenceGood
caring: Privacy and dignityGood
responsive: Person-centred care planningGood
responsive: Complaints handlingGood
responsive: Social inclusion and activitiesGood
well-led: Governance and oversight systemsRequires improvement
well-led: Leadership and cultureGood
well-led: Staff engagement and meetingsRequires improvement
well-led: Seeking feedback from peopleRequires improvement
MADeBA Care Ltd (Excalibur Serviced Offices) improved from Requires Improvement to Good across all five key questions at this February 2019 inspection, with notable progress in staff training and governance systems. A minor gap was identified in care planning, where assessments did not consistently incorporate input from relevant health professionals.
Concerns (1)
minorCare planning: “the assessments did not always contain information gathered from other relevant health professionals...a plan to manage a person's anxieties only contained information given by their relatives.”
Strengths
· Staff had good understanding of safeguarding procedures and knew what to report, who to report to and when.
· Robust recruitment practices ensured only suitable staff were employed.
· Sufficient staffing levels maintained, including two-staff support where required, with no missed calls recorded.
· Training gaps identified at previous inspection had been addressed; staff completed the Care Certificate and refresher training.
· Person-centred approach with care plans individually tailored; relatives reported high satisfaction with dignity and respect shown.