critical“Four staff were providing care without a Disclosure and Barring Service (DBS) check. A DBS check is required by law to prevent unsuitable staff from working with people who required care.”
record keeping
1 finding
moderate“Accident and incident records were incomplete...the records did not contain information of who was investigating the potential impact on people or what actions were taken to minimise risk.”
governance
1 finding
critical“Audits identified the same issues each month...no actions taken to address them were documented. This was a breach of regulation 17 (Good Governance).”
incident learning
1 finding
moderate“Systems were not in place to identify trends of concerns reported or to learn from things which had gone wrong.”
care planning
1 finding
moderate“Records with checking and auditing people's care and support plans were inconsistent in the level of detail they contained.”
complaints handling
1 finding
minor“Feedback we received on the handling of complaints was mixed...We have spoken to management about this and that we often cancel visits, but the staff still come to the house.”
leadership
1 finding
critical“Issues identified on inspection were known to the provider prior to our visit. These issues were not brought to our attention until discovered by inspector.”