Date of assessment 15 October to 17 December 2024. Reason for assessment: our assessment was brought forward due to risk. Happy at Home Community Care Services Ltd is a domiciliary care agency providing support to people in their own homes. People were kept safe and risks to their safety were managed. Improvement had been made to management of people’s medicines. Improvement had also been made to care records, as care plans and risk assessments had been put in place since the previous inspection. Some areas of good governance had also improved since the previous inspection. The service was no longer in breach of regulations. People were supported by staff who had been recruited using robust processes and who received training and supervision. There were processes for staff to raise concerns. Workforce diversity was celebrated and the provider worked well with external agencies. Referrals were made to other agencies where necessary, to ensure people received the right support. Surveys were sent to people to ask about the quality of their care and also to staff. Improvements were needed to some of the care records and being able to demonstrate continuous learning and service development.
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Multi-Care Community Services Reading Ltd was rated Requires Improvement following a focused inspection of safe and well-led, with breaches of Regulations 12 and 17 identified relating to inadequate risk assessments, unsafe medicines management practices, and ineffective governance systems. Strengths included kind and compassionate care, safe recruitment, good safeguarding awareness, and an open management culture.
Concerns (9)
criticalMedication management: “Individual protocols for the use of 'when required' (PRN) medicines were not available. This was a finding of the previous inspection.”
criticalMedication management: “In four cases, the transcriptions did not specify the dose of medicine required. Failing to state the required dose on a MAR could put the person at risk of receiving the wrong dose.”
criticalCare planning: “People's risk assessments did not contain clear and detailed guidance for staff to protect people from the risk of harm.”
criticalCare planning: “Comprehensive care plans and risk assessments were not available for all people... this put people at risk of not receiving appropriate and safe care.”
criticalGovernance: “The registered manager had not established an effective system to enable them to ensure compliance with their legal obligations and the regulations. Regulation 17 (1, 2, a, b, c)”
moderateIncident learning: “The management team had not analysed themes and trends in the accident and incident reports, and ensured measures were in place to reduce the likelihood of repeat events.”
moderateSupervision / appraisal: “Supervision records identified that some staff members had not received supervision for at least four months. This was not in line with the provider's policy.”
minorMissed or late visits: “There had been times were staff were more than 30 minutes late to the agreed time. One person told us, 'I've had occasional missed calls'.”
minorRecord keeping: “A person was due to have their morning call at 9am, however, staff had arrived at 6:30am... audits had failed to identify a disparity between the time a staff member arrived and the scheduled time.”
Strengths
· Staff promoted equality and diversity; people received kind and compassionate care and staff respected privacy and dignity.
· Safe recruitment procedures were in place including DBS checks and evidence of conduct from previous roles.
· All staff had received safeguarding training and could explain the process for raising concerns.
· All staff had received infection control training and PPE was used effectively.
· Staff felt managers were accessible, approachable and transparent; staff knew how to raise concerns.