Pechiv Care Services was rated Requires Improvement overall following a January 2017 inspection, with an Inadequate rating for well-led due to a continuing breach of Regulation 17 — no quality monitoring systems, no registered manager, and operation from an unregistered location. Care delivery was generally positive, with Good ratings across effective, caring and responsive domains, though incomplete risk assessments in the safe domain prevented a Good overall rating.
Concerns (6)
criticalGovernance: “The provider could not demonstrate that there were formal systems in place to monitor the quality of care provided.”
criticalGovernance: “There was no system in place for the provider to be sure that people received their visits from staff. The only way the provider would know if a visit had been missed was if a person called.”
criticalLeadership: “There was not a registered manager in post. The service was also operating from a location that was not part of the conditions of their registration.”
moderateCare planning: “One risk assessment stated the person could not bear weight and needed a hoist for all transfers...but there was no detailed guidance for staff relating to the risk or how to hoist the person safely.”
moderateRecord keeping: “The last recorded training date displayed was 23 July 2015...Another depicted a care plan review schedule. No current review dates were listed. The last recorded date was 2 July 2015.”
moderateIncident learning: “There was no system in place to monitor and analyse accidents or incidents to look for patterns or trends.”
Strengths
· People told us they felt safe and staff understood safeguarding responsibilities, including external reporting routes
· Sufficient staffing levels maintained; people reported staff were punctual and no missed visits experienced
· Safe recruitment procedures followed including DBS checks and employment references
· Medication records accurately maintained and staff competency regularly checked
· Staff received regular supervision, spot checks and appraisals; all four reviewed staff were engaged in further qualifications
Quality-Statement breakdown (15)
safe: Risk assessments in place but not all contained detailed guidance for staff on managing identified risksRequires improvement
safe: Sufficient staffing deployed; visits punctual and no missed visits reportedGood
safe: Medication administration records accurately maintained; staff trained and competency checkedGood
safe: Safe recruitment procedures including DBS checks followedGood
effective: Staff supervision, spot checks and appraisals scheduled and conducted; staff engaged in further qualificationsGood
effective: Staff trained in MCA and applied principles; consent sought appropriatelyGood
effective: People's nutritional needs assessed and met; healthcare professionals involved in careGood
caring: Staff kind, compassionate and respectful; people's dignity and privacy protectedGood
caring: People's independence actively promoted by staffGood
responsive: Care plans personalised with people's histories, preferences and individual needsGood
responsive: Complaints policy in place; people confident concerns would be acted uponGood
responsive: Care regularly reviewed; people and families involved in reviewsGood
well-led: No formal quality monitoring systems or audits in place; breach of Regulation 17Inadequate
well-led: No registered manager in post; service operating from unregistered locationInadequate
well-led: Staff meetings held regularly; learning and care updates shared with staffGood
Pechiv Care Services was rated Requires Improvement overall at its February 2015 inspection, with two regulatory breaches cited for failing to provide formal supervision and appraisals (Regulation 23) and for inadequate quality assurance systems and record keeping (Regulation 10). The service demonstrated genuine strengths in safe staffing, caring practice, and responsiveness to health needs, but lacked the governance infrastructure to evidence and sustain consistent service quality.
Concerns (6)
criticalSupervision / appraisal: “Staff had not received regular formal supervision and appraisals to monitor their performance and development needs.”
criticalGovernance: “The provider could not demonstrate that there were formal systems in place to monitor the quality of care provided.”
criticalRecord keeping: “For one person we found no records of visits and communication sheets since 18 May 2014, fluid chart records since 12 January 2014.”
moderateStaff training: “Not all staff we spoke with had received training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).”
moderatePerson-centred care: “We could not find evidence in people's care plans about people's personal histories, likes and dislikes.”
moderateIncident learning: “The provider could not demonstrate how concerns and complaints reported were used as an opportunity for learning and development.”
Strengths
· People felt safe with staff and relatives reported no missed calls, with staff communicating proactively about late arrivals.
· Staff demonstrated kind, compassionate and respectful care, and people reported positive relationships with a consistent team.
· Staffing levels were adequate with a standby staff member to cover absences.
· Staff promoted people's independence and responded quickly to changing health needs.
· Staff had completed induction training including moving and handling, safeguarding, and infection control.
Quality-Statement breakdown (14)
safe: Staffing levelsGood
safe: SafeguardingGood
safe: RecruitmentGood
effective: Supervision and appraisalRequires improvement
effective: Staff training (MCA/DoLS)Requires improvement
Pechiv Care Services received an overall rating of Good across all five key questions at its March 2020 inspection, maintaining the rating from its previous 2017 inspection. The service demonstrated personalised, safe and well-managed care for eight people, supported by a strong registered manager, effective quality assurance systems and a committed staff team.
Strengths
· People told us staff were caring and kind, with strong long-term relationships between staff and people they supported.
· Sufficient staffing levels maintained, with consistent deployment of two staff where required and punctual visit attendance.
· Medicines managed safely by trained and competent staff with spot checks in place.
· Personalised care plans reflecting individual needs, preferences, likes and dislikes, regularly reviewed and updated.
· Effective quality assurance systems including audits of medicine records, care planning, staff files and satisfaction surveys.
Quality-Statement breakdown (23)
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: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
Pechiv Care Services was rated Good overall following an announced inspection on 14 August 2017, with improvements confirmed across safe, effective, caring and responsive domains since the previous inspection. Well-led was rated Requires Improvement as governance and quality assurance improvements, though underway, needed to be fully embedded and sustained.
Concerns (2)
criticalGovernance: “We inspected again in January 2017 and found there was still no thorough system of monitoring the effectiveness of the service.”
moderateGovernance: “We need to ensure that the improvements made are embedded into the service and that they are sustainable.”
Strengths
· People received their medicines as prescribed and staff competence was verified through direct observation
· People felt safe and relatives had confidence in staff's ability to keep people safe
· Staff received safeguarding training and understood their responsibilities
· Robust pre-employment checks including DBS were in place
· New staff received a structured five-day induction with mandatory training and shadowing
caring: Promotion of independence
Good
responsive: Person-centred care planningRequires improvement
responsive: Complaints handlingGood
well-led: Quality assurance and auditRequires improvement
well-led: Record keeping and governanceRequires improvement
well-led: Acting on feedbackRequires improvement
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: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood