Sagecare Fulham improved from its previous Requires Improvement rating to Good overall at its October 2022 inspection, with previous breaches of regulations 9, 12, 17 and 18 remedied. Well-led remained Requires Improvement due to inconsistent and sometimes contradictory care plan recording, and ongoing issues with the timeliness of some care visits.
Concerns (6)
moderate
Record keeping
: “Some information was not always recorded in people's care plans in a consistent manner...some cases it was not always clear how a person had consented to their care plan or to the use of bed rails”
moderateGovernance: “Some information was also contradictory. For example, while there was appropriate information for staff on the mobility support a person needed, other sections of their plan stated they did not need this.”
moderateMissed or late visits: “[Care staff] seem to be in a rush to go" and "I sometimes think that some of the carers just want to do the bare minimum and then leave."”
minorConsent / capacity: “When a person was not able to sign to consent to their care plan arrangements...the provider had not always clearly recorded this and how the person had otherwise indicated their consent.”
minorInfection control: “Most people and relatives told us staff wore personal protective equipment (PPE), but two relatives said this was not always the case.”
minorCommunication with families: “Some felt there could be better communication between care staff and the office team so staff were always aware of people's needs.”
Strengths
· Staff treated people with dignity, respect and kindness, with people and relatives speaking positively about care workers
· Medicines management improved since last inspection; staff assessed for competency and subject to regular spot checks
· Robust safeguarding procedures in place including training, themed supervisions and whistleblowing awareness
· Sufficient recruitment processes including DBS checks and employment history verification
· Electronic call monitoring systems used to supervise care visits and respond to lateness
Quality-Statement breakdown (23)
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
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
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 supportGood
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 empoweringGood
well-led: Continuous learning and improving care; duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood