Amicus Homecare Ltd received a 'Requires Improvement' overall rating following a focused inspection of Safe and Well-Led, with breaches identified across safeguarding (Reg 13), safe care and treatment (Reg 12), and good governance (Reg 17). Key failures included unrecognised safeguarding incidents, absent risk assessments in care plans, unsafe medicines recording, and ineffective audit and governance systems.
Concerns (10)
critical
Safeguarding
: “Two incidents which should have been safeguarded had not been recognised by the management. No alerts to the local authority safeguarding team or CQC had been made in line with legislation.”
criticalMedication management: “Medicines records did not meet best practice requirements as they did not contain details of individual medicines administered.”
criticalGovernance: “Audits were inconsistently completed or did not exist. For example, audits for accidents and incidents contained months that were blank.”
criticalCare planning: “People's care plans contained no risk assessments meaning staff could provide inconsistent and unsafe care.”
moderateIncident learning: “A second group of electronic incidents were shared by one of the directors. The registered manager was unaware of this second group, so they had not been reviewed.”
moderateStaff training: “6 out of 13 staff had not received training in safeguarding and some had only read the company policy as their training.”
moderateRecord keeping: “The provider had recently introduced several digital systems. This had led to gaps in people's care records including a lack of assessing risks.”
moderateLeadership: “The directors and registered manager lacked knowledge on current legislations, guidance and standards.”
minorInfection control: “No individual COVID-19 risk assessments had been completed during the pandemic unless the person was COVID-19 positive. This was not in line with government guidance.”
minorSupervision / appraisal: “The systems to listen to staffs' views and those of people who use the service had not been utilised for over a year.”
Strengths
· People and relatives were positive about staff, describing them as kind, caring and safe.
· Staff knew how to safely use PPE and had consistent access to it.
· Sufficient staffing levels maintained with systems to manage lateness.
· Registered manager completed inductions and ensured staff were confident before lone working.
· Management working in partnership with local authority to support health care system pressures.
Quality-Statement breakdown (12)
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Preventing and controlling infectionRequires improvement
safe: Using medicines safelyRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement
well-led: Managers and staff being clear about their roles and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Continuous learning and improving careRequires improvement
well-led: How the provider understands and acts on the duty of candourRequires improvement
well-led: Engaging and involving people using the service, the public and staffRequires improvement