ReadyCQC, a weekly field guide to CQC home-care regulation

Inspection report · 2021-10-30

Framework: KLOE · 14 pages · 89 KB · PDF

Good

safe: Requires improvementeffective: Insufficient evidence to ratecaring: Insufficient evidence to rateresponsive: Insufficient evidence to ratewell-led: Good

Premium Care Solutions Limited received an overall Good rating following a pilot virtual inspection in October 2020, but was rated Requires Improvement for safe due to significant medication management failures including incomplete MAR charts, missing PRN guidance, inadequate PEG medicine recording, and gaps in staff competency assessments. Well-led deteriorated from Outstanding to Good as audits had failed to identify the medication record concerns found during inspection, though the provider responded promptly with an action plan.

Concerns (7)

criticalMedication management: “Prescribed medicines recorded on MAR charts were inconsistent. Some directions for oral medicines were incomplete and some coding systems were not consistently in place.”
criticalMedication management: “We found gaps on some MAR charts. Staff had not completed the records to evidence whether the medicine had been administered.”
criticalMedication management: “When people had their medicines given to them via a tube through their skin (PEG), records did not show that the service had taken appropriate professional advice.”
moderateStaff competency: “Some members of care staff had not had their competence assessed annually in line with national best practice guidance.”
moderateRecord keeping: “Care plans did not always cross reference people's needs. Information was not cross referenced for a person who required equipment and another who required rescue medicine.”
moderateGovernance: “The medicine audits had not identified the concerns we found during the inspection. The provider agreed to ensure improvements were made after inspection.”
moderateCare planning: “One person's records did not evidence that staff were consistently following the strategies regarding repositioning.”

Strengths

· People were supported by a consistent staff team who knew them well and had received training on their specific needs.
· Staff were recruited safely with DBS checks and references obtained; people and relatives were invited to participate in the recruitment process.
· Staff wore appropriate PPE and had received infection control training; people and relatives confirmed consistent PPE use.
· People and relatives were positive about care quality; staff were described as kind, compassionate and understanding of individual needs.
· People were supported to maintain independence and were involved in care planning and decision-making.

Quality-Statement breakdown (18)

safe: Using medicines safelyRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
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

Inspection reports (3)