QCM Healthcare, a small domiciliary care agency in Colchester, was rated overall Good at its November 2022 inspection, having improved from Requires Improvement in 2018 and resolving all previous regulatory breaches. The single remaining weakness was in Effective, where care plan quality and staff competency assessment processes were inconsistent, particularly for staff new to care or taken on at short notice.
Concerns (4)
moderate
Staff competency
: “the registered manager had not adequately assessed or reviewed these staff's training and skills to ensure they understood how to apply what they had learnt to their daily practice.”
moderateCare planning: “Where care was being provided at short notice, care plans and guidance to staff was not always sufficiently detailed or presented in a clear way.”
minorRecord keeping: “some records were a 'tick-box' exercise and did not reflect what senior staff had learnt from observing staff, especially when staff were new to care and developing new skills.”
minorPerson-centred care: “Some people's care plans lacked personal information about their background and interest and were largely task-based, detailing what staff needed to do or what someone's medical history was.”
Strengths
· Recruitment processes were fully revised and improved, including a tracking system for checks and references, with no staff starting before DBS checks were completed.
· Staff understood safeguarding responsibilities and felt able to speak up; training on recognising and reporting abuse was in place.
· Medicines were administered, recorded and stored safely, with regular competency checks and STOMP principles applied.
· Infection prevention and control was effective, with spot checks on PPE use and up-to-date policies.
· The service supported end of life care, enabling people to be cared for at home in line with their wishes.
Quality-Statement breakdown (19)
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietRequires improvement
effective: Supporting people to live healthier lives, access healthcare services and support; Staff working with other agenciesGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
responsive: Planning personalised care to ensure people have choice and control; End of life care and supportGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; Continuous learning and improving careGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people, the public and staff; duty of candour; working in partnershipGood