Vibrant Home Care was rated Requires Improvement overall following an August 2023 inspection, with breaches of Regulation 12 (safe care and treatment) and Regulation 17 (good governance) identified due to incomplete risk assessments, unanalysed incidents, and ineffective audit processes. Strengths included safe medicines management, adequate staffing, strong end of life care, and positive feedback from people and relatives about care staff.
Concerns (10)
criticalCare planning: “Care plans for people who had sustained pressure damage did not provide information from the district nursing team, such as, the stage of their sore.”
criticalGovernance: “All audits were completed on the first day of each month and findings were copied over each month word for word.”
criticalIncident learning: “The management did not collate all falls and injuries to see if there were any emerging trends and patterns to address.”
criticalSafeguarding: “Unexplained bruises to people had not always been investigated to establish whether a safeguarding referral to the local authority or further medical involvement was required.”
moderateInfection control: “They are leaving used personal protective equipment (PPE) all over the house. Clothing dropped and left on the floor.”
moderateComplaints handling: “Not all complaints had been recorded in accordance with the provider's policy... the registered manager was unable to establish any emerging trends and patterns.”
moderateRecord keeping: “People's communication needs were not always included in their care records. Some people were unable to use words to communicate... This information had not been included in the people's care plans.”
moderateSupervision / appraisal: “Supervision forms prompted the supervisor to ask questions and undertake observations, these were not always completed.”
moderateStaff competency: “The registered manager was unable to provide evidence of additional training to equip office staff to complete these duties.”
minorMissed or late visits: “Missed and late visit logs showed some visits were consistently cut short. Where this may have been the person's choice, there was no documented analysis carried out.”
Strengths
· Medicines were managed safely; staff were trained and assessed as competent before administering medicines.
· Staff received training relevant to their role including specialist training for equipment such as PEG feeding tubes and oxygen therapy.
· Sufficient staffing levels with no missed calls; people did not feel rushed and staff arrived within allocated timeslots.
· Safe recruitment practices including pre-employment reference checks and DBS checks.
· Strong end of life care with improvements since last inspection; good working relationship with local hospice.
Quality-Statement breakdown (20)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Preventing and controlling infectionRequires improvement
safe: Using medicines safelyGood
safe: Staffing and recruitmentGood
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
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
responsive: Improving care quality in response to complaints or concernsRequires improvement
responsive: Meeting people's communication needsRequires improvement
responsive: Planning personalised care to ensure people have choice and controlRequires improvement
responsive: End of life care and supportGood
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: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
Vibrant Home Care (Ashford) received an overall rating of Good at its first CQC inspection in February 2023, with four of five key questions rated Good. The service was rated Requires Improvement for responsive care due to insufficient flexibility in accommodating changes to care packages and a lack of documented end-of-life wishes for people using the service.
Concerns (2)
moderatePerson-centred care: “some people had mentioned that there had at times been a lack of flexibility regarding changes to care packages. There were instances when people had requested changes, but this had been dismissed”
minorEnd-of-life care: “People were not always asked about their wishes and preferences at the end of their lives. This is an area for improvement.”
Strengths
· People felt safe with staff; safeguarding training was in place and staff knew how to escalate concerns appropriately.
· Risks were thoroughly assessed and mitigated, with care plans updated when needs changed.
· Consistent staffing ensured continuity of care; no missed calls reported and late calls were investigated.
· Medicines were managed safely with competency assessments, spot checks and multi-level auditing.
· Staff had regular training (online and in-person), induction, shadowing, supervisions and competency assessments.
Quality-Statement breakdown (25)
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
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
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 preferencesRequires improvement
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood