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JADE Healthcare Services is a home care service providing support to older people and younger adults, people living with dementia, people with physical disabilities and learning disabilities. At the time of the assessment, there were 17 people being supported, all who were receiving the regulated activity of personal care. This was a comprehensive assessment as this service had not been inspected before. We used a range of different methods to help us understand people's experiences. These included reviewing documents, speaking with employees and contacting people who used the service and their relatives for their views on care they receive. We found significant shortfalls in care planning and risk assessments within the service, meaning that people were at risk of receiving unsafe care and treatment. Accidents and incidents were not always recorded formally or analysed to reduce the risk of reoccurrence. This meant safeguarding referrals had the potential to be missed by the provider and placed people at continued risk of harm or abuse. Risk assessments were not always in place when clinical needs had been identified which meant the provider could not be assured staff knew how to manage these risks. People and their relatives spoke positively about the kindness and attentiveness of individual staff, however, the assessment found that care was not always person-centred or delivered in line with best practice. Care plans lacked information about people's choice and preferences. Staff were positive about the management and support they received as employees of the service. They told us they felt valued and listened to. During the assessment, we found 2 breaches in regulations of safe care and treatment and good governance. In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.
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