ReadyCQC, a weekly field guide to CQC home-care regulation

Inspection report · 2021-10-30

Framework: KLOE · 20 pages · 88 KB · PDF

Inadequate

safe: Inadequateeffective: Inadequatecaring: Requires improvementresponsive: Requires improvementwell-led: Inadequate

Livingstone Health Care Limited received an overall Inadequate rating at its first inspection, with three key questions rated Inadequate and enforcement Warning Notices issued for breaches of Regulations 12 and 17 relating to unsafe medicines management and systemic governance failures. Widespread shortfalls were identified across risk assessments, consent, staff training, supervision, care planning and safeguarding, resulting in the service being placed in special measures.

Concerns (10)

criticalMedication management: “Medicines were not being managed safely. The service told us they did not support people with medicines. However, two staff we spoke to told us they supported people with medicines such as taking the medicines out of blister packs.”
criticalCare planning: “Care plans were not person centred and lacked details on people's support needs... information on some care plans indicated that staff should support people with personal care without including the type of personal care required.”
criticalGovernance: “There was lack of robust audit systems in place to identify shortfalls and take prompt action to ensure people received safe high-quality care.”
criticalConsent / capacity: “Assessments had not been completed to determine if people had capacity using the MCA principles... The service had not sought consent from people prior to delivering care and support.”
criticalStaff training: “Four staff had not completed key training to perform their roles effectively. One staff member last completed training in 2012 when working for another care agency.”
moderateSupervision / appraisal: “Regular supervisions had not been carried out in accordance with the provider's supervision policy. Some staff, recruited in November and December 2018, had only received one supervision.”
moderateSafeguarding: “The provider's safeguarding policy was last updated in October 2016. The policy did not include the types of abuse and who staff could report to externally other than the police.”
moderateRecord keeping: “Some daily logs did not include the person's name or date of birth, which meant it would be difficult to identify the person who received that support.”
moderatePerson-centred care: “Robust pre-assessments systems were not in place to ensure people received support in a person-centred way. Care plans were brief and were not person centred.”
minorCultural competency: “On two referral forms people's religion had not been included... both people were from a specific religious background and may have had specific preferences about the support they received.”

Strengths

· Pre-employment checks including criminal record checks, references and proof of identity had been carried out for all staff.
· Staff were punctual and a digital monitoring system was in place to oversee visit times and durations.
· Staff were caring, kind and compassionate; people reported positive relationships with their carers.
· People's privacy and dignity were respected during personal care.
· Systems were in place for infection control and staff had access to PPE.

Inspection reports (5)