South Tees Home Support Service, a domiciliary care agency supporting eight children and young people with disabilities, was rated Good across all five key questions at this January 2020 inspection. The service had successfully addressed the previous Regulation 17 breach related to governance and training monitoring, with only minor record-keeping and audit scheduling improvements still required.
Concerns (3)
minor
Governance
: “there was no defined schedule of provider level audits. We discussed this with the provider and registered manager who told us provider audits would be scheduled to take place on a quarterly basis in future.”
minorRecord keeping: “The registered manager did not document non-formal complaints and their outcomes at the time of inspection.”
minorMedication management: “A medicines policy was in place which required updating. The registered manager told us this work would be undertaken.”
Strengths
· Staff were consistently kind and caring, with very positive feedback from relatives and professionals.
· Robust recruitment procedures and appropriate staffing levels met the needs of children and young people.
· Comprehensive, regularly reviewed care plans developed collaboratively with families and professionals.
· Staff received appropriate training including safeguarding, infection control, and mandatory training monitored via an up-to-date training matrix.
· Regular supervision, team meetings, and staff development days supported staff practice.
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staff; Continuous learning and improving careGood
South Tees Home Support Service was rated Requires Improvement overall following a January 2019 inspection, with one breach of Regulation 17 identified due to ineffective governance systems failing to monitor and record staff training and quality assurance. Strengths included safe risk management, caring and person-centred practice, strong multi-agency working, and positive feedback from relatives and external professionals.
Concerns (3)
criticalStaff training: “Some training expired in 2017. The chart also showed that some staff had never completed mandatory training in some areas such as fire safety and infection control despite having worked at the service for a number of years.”
criticalGovernance: “A 'registered manager's monthly monitoring form'...had last been recorded as completed in March 2017...There was no record of any quality assurance checks or systems carried out by the provider.”
moderateRecord keeping: “Training records were not always up-to-date or reflective of training completed...The registered manager said they were sure training had taken place and that the training chart was not accurate.”
Strengths
· Risks to people were assessed and plans put in place to reduce the chances of them developing, with staff knowledgeable about people's support needs.
· Effective infection control policies and procedures in place; staff provided with all necessary PPE.
· People were safeguarded from abuse; staff demonstrated good knowledge of abuse types and reporting procedures.
· Staff supported with regular supervision and appraisal, with records showing meetings used to review knowledge and performance.
· Relatives and external professionals spoke positively about caring, kind staff who treated people with dignity and respect.