Fuchsia Homecare Colchester was rated Requires Improvement overall following a focused inspection of Safe and Well-led, driven by concerns about care visit timings and durations and a governance breach under Regulation 17. A systemic pattern of shortened and mistimed care visits dating back to June 2022 demonstrated inadequate quality oversight, though medicines management, safeguarding processes, and staff recruitment were found to be safe.
Concerns (7)
criticalMissed or late visits: “people's care visits were significantly shorter than the agreed duration, with many only lasting half of the allocated time.”
criticalGovernance: “The provider had not ensured effective processes were in place to monitor and improve the safety and quality of the service. This was a breach of Regulation 17”
criticalIncident learning: “where the provider had identified people with shortened care visits in June 2022, we found the some of the same people were still receiving shortened visits in November 2023.”
moderateStaffing levels: “The provider had not always ensured there were sufficient numbers of staff available to meet people's needs in a timely way.”
moderateCare planning: “some risk assessments lacked detailed guidance about what the specific risks were and how to keep people safe.”
moderateLeadership: “The service did not have a registered manager in post at the time of the inspection and there had been several changes in management oversight and structure since our last inspection.”
minorPerson-centred care: “where people had raised issues during their monthly telephone reviews, the provider had sometimes written 'no action required' in response.”
Strengths
· People were supported to take their medicines safely via an electronic medicines administration record monitored in real time.
· Staff knew how to recognise and report concerns or signs of abuse and people told inspectors they felt safe.
· The provider operated safe recruitment processes with appropriate employment checks completed prior to staff starting work.
· Staff received infection prevention and control training and PPE compliance was monitored through regular people/relative feedback.
· The provider worked in partnership with health and social care professionals who described them as open, honest and responsive.
Fuchsia Homecare Colchester received a 'Requires Improvement' rating across all five key questions at its first inspection in October 2018, with seven regulatory breaches identified including failures in safeguarding, recruitment, medicines management, consent, care planning, complaints handling, and governance. While staff were described as kind and caring and sufficient in number, significant systemic failings in oversight, staff training, and record-keeping placed people at risk of harm.
Concerns (13)
criticalSafeguarding: “None of the staff we spoke with were able to demonstrate an understanding of local safeguarding protocols and some were unable to understand what we were asking due to their limited command of the English language.”
criticalStaff competency: “Safety checks had not always been carried out prior to staff started working unsupervised. We found two staff members where the provider had not obtained character references.”
criticalConsent / capacity: “The management team lacked knowledge of their regulatory roles and responsibilities in relation to the Mental Capacity Act 2015 (MCA) and associated Deprivation of Liberty Safeguards (DoLS).”
criticalStaff training: “Staff had not always received the quality and range of training they required to meet people's needs and equip them for the role they were employed to perform.”
criticalCare planning: “We found one person who had started using the service the week prior to our visit did not have a care plan in place.”
criticalGovernance: “These checks had not identified all the shortfalls we found at this inspection. For example, the management of risk, complaints review and analysis.”
criticalIncident learning: “The management team did not recognise that by not using the lap strap this left the person at risk and they had not taken any additional action to mitigate the risk of harm.”
moderateMedication management: “Where people were prescribed topical medicines such as creams and lotions there was no body map in place and no support plan instructing staff as to where to apply the prescribed medicine.”
moderateComplaints handling: “15 complaints had been received since April 2018...there was no overview of the complaints that had been received to ensure that these could be analysed to identify any themes or trends.”
moderateSupervision / appraisal: “Where spot checks had identified areas for improvement, there was no follow up action evidenced to ensure that the staff member improved these areas.”
moderateCultural competency: “Staff where their first language was not English did not always understand their needs... 'lines get crossed, this can be very tiring.'”
moderateRecord keeping: “'Staff must limit the amount of detail they write in care records e.g. don't detail what was eaten just that the person ate well.' This is contrary to recognised good practice guidance.”
minorEnd-of-life care: “There was no information within care plans which would provide guidance as to people's assessed wishes at the end of life or if they needed palliative care.”
Strengths
· People told us staff were kind, caring and respectful, with relatives describing staff as 'fantastic'
· There were enough staff to meet people's needs and people reported consistent, punctual carers
· Staff used personal protective equipment and infection prevention guidance was available in care plans
· People were supported with nutrition, hydration and healthcare appointments where part of their care package
· Management team was accessible, approachable and acknowledged areas needing improvement
Quality-Statement breakdown (19)
safe: Safeguarding systems and whistleblowing guidanceRequires improvement
Fuchsia Homecare Colchester improved from Requires Improvement to Good across all five key questions, having remediated all previous regulatory breaches. Minor gaps remain around real-time monitoring of missed and late calls, formal recording of mental capacity assessments, and the absence of end-of-life care plans.
Concerns (3)
moderateMissed or late visits: “the service did not have robust systems in place to monitor missed and late visits in real time.”
minorRecord keeping: “People's capacity was assessed by the service in line with the MCA 2005. However, the service did not formally record this or discussions they had with people.”
minorEnd-of-life care: “Documents to record the arrangements, choice and wishes people may have for the end of their life were not in place to ensure peoples final wishes were met.”
Strengths
· All previous breaches of regulation remediated since last inspection (Requires Improvement, October 2018)
· Medicines systems were organised and people received their medicines when they should; staff received training and competency assessments before administering medicines
· Staff understood safeguarding responsibilities; people and relatives consistently reported feeling safe
· Robust risk assessments in place prior to care starting, regularly reviewed and updated
· Safe recruitment processes with staff-completed audits of recruitment files
effective: Supervision and appraisal qualityRequires improvement
effective: Nutrition, hydration and healthcare supportGood
caring: Dignity, respect and person-centred approachGood
caring: Communication with people (language barriers)Requires improvement
caring: Privacy and dignity in practiceRequires improvement
responsive: Care planning and person-centred care (Regulation 9)Requires improvement