First inspection of a small domiciliary care agency rated Good overall, with positive feedback from people and relatives about safe, caring and personalised support. Well-led was rated Requires Improvement because quality assurance failed to identify shortfalls in PEG care planning, specialist training coverage, and task-oriented language in care logs.
Concerns (5)
moderate
Governance
: “Quality assurance checks completed by the provider were not always effective at identifying improvement or recognising shortfalls.”
moderateCare planning: “Care planning and risk assessments failed to include guidance on the signs and symptoms that the PEG site might be infected or blocked.”
moderateStaff training: “not all staff had receiving training on these key topics. Therefore, in the event of a staff member being unable to cover a care call, alternative staff had not received training”
minorPerson-centred care: “regular reviews of these logs failed to identify that the language used by staff was often task oriented and not person centred. For example... 'fed' and 'changed their nappy.'”
minorRecord keeping: “Further work was required to ensure documentation clearly reflected the actions taken by staff to keep people safe.”
Strengths
· People and relatives reported feeling safe and happy with care provided
· Consistent staff members who knew people's needs well
· Safe recruitment practices including DBS and identity checks
· Strong infection control practices and PPE use, praised by relatives
· Comprehensive induction including Care Certificate for new staff
Quality-Statement breakdown (21)
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: Staff working with other agencies; supporting people to access healthcare servicesGood
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 preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement
well-led: How the provider understands and acts on the duty of candour; working in partnership with othersRequires improvement