The Robert Atkinson is registered to provide personal care to individuals living in their own homes and they primarily offer services to older people. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. The service was specifically set up to deliver support for the local BME communities. At the time of the inspection 24 people were using the service who received personal care. We carried out an onsite and offsite assessment. Activity started on 9 July and ended on 5 September 2024. We gathered information from people using the service, relatives, the provider who is also the registered manager, office staff, care workers and from visiting professionals. We looked at 21 quality statements. At the last inspection appropriate recruitment checks were not followed and the systems in place to monitor the safety and quality of the service were ineffective. Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 12 and 17. The provider had employed a company to assist them improve the governance systems. Immigration service staff had visited the service to check safe recruitment arrangements were in place. The provider had worked with a legal team to ensure they followed sponsorship scheme requirements. Staff understood people's needs and how to manage any presenting risks. The registered manager as a part of their lessons learnt process was reviewing risk assessment to ensure where people had complex needs, staff had very detailed guidance to follow. Staff worked with people to design care packages, which met their needs and were achievable within the set timeframe. Staff sought people’s views about how to support them. Overall staff felt their views were listened to and their well-being was promoted.
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The Robert Atkinson Centre, a small domiciliary care agency serving 5 people, was rated Requires Improvement following a focused inspection that identified regulatory breaches in safe recruitment (Regulation 19) and good governance (Regulation 17). Despite positive feedback from people and effective safeguarding and risk management practices, the absence of robust quality assurance and incomplete DBS checks represented significant oversight failures at both manager and provider level.
Concerns (4)
criticalGovernance: “Quality assurance processes were not in place or were ineffective. The issues we identified had not been recognised and addressed.”
criticalStaff competency: “The provider did not ensure staff were recruited safely. The service did not always carry out recruitment checks, and DBS checks were not always conducted.”
moderateLeadership: “The registered manager was also the nominated individual...the lack of oversight was at both registered manager and provider level.”
moderateRecord keeping: “The registered manager did not have effective systems to monitor recruitment files were accurate and complete.”
Strengths
· People were supported by a consistent staff team and new staff were introduced to people prior to supporting them.
· The registered manager ensured staff had appropriate language and cultural links with the person they supported.
· Environmental and individual risks were identified with risk assessments and contingency plans in place.
· Staff had completed safeguarding and infection control training; PPE was used appropriately.
· The registered manager was proactive within the local BAME community and regularly visited people to gather feedback.
Quality-Statement breakdown (10)
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuse; Learning lessons when things go wrongGood
safe: Assessing risk, safety monitoring and managementGood
safe: Preventing and controlling infectionGood
safe: Using medicines safelyNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Working in partnership with othersGood
well-led: How the provider understands and acts on the duty of candourGood