Date of assessment 11 April to 28 April. Oasis Care is a is a domiciliary care service, providing care to people living in their own home. At the time of our assessment the agency was supporting 200 people. We carried out this assessment due to information of concerns we had received about the service. We assessed all the quality statements from the safe, responsive, effective, caring, and well-led key questions. Although the assessment of these quality statements indicated areas of concern since our last inspection, our overall rating for the service has changed from inadequate to requires improvement. The service is no longer in special measures. We found 4 breaches of the legal regulations in relation to, safe care and treatment, good governance, person centred care and consent to care. Where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded. CQC have used the guidance for Right Support, Right Care and Right Culture to assess this service . The service did not always demonstrate how they were meeting these principles. We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. Staff did not always assess risks to people's health and safety or mitigate them where identified. People did not always have care plans to guide safe practice. Governance systems and audits were not effective in identifying or addressing areas for improvement. However, there were effective systems in place to recruit and deploy staff safely.
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OASIS West London Office was rated Inadequate overall following an unannounced inspection in October 2023, representing a significant decline from its previous Good rating in January 2021. Multiple regulatory breaches were identified spanning unsafe recruitment, medication management failures, inadequate care planning, absent supervision records, ineffective governance, and non-compliance with the Mental Capacity Act.
Concerns (15)
criticalStaffing levels: “Staff were not always given enough travel time in between calls...On occasions when staff were late the person waiting was not made aware of this.”
criticalStaff training: “Staff did not have training on the Mental Capacity Act (MCA).”
criticalMedication management: “People's care plans did not detail how to support them with their medicines...There were no records available to inform staff about the medicines' side effects.”
criticalCare planning: “Risk assessments did not have detailed personalised guidance and strategies for staff to follow to help monitor, manage, and minimise risks.”
criticalGovernance: “The provider had not implemented their quality assurance and management policy. Their quality assurance systems did not identify concerns we found on this inspection.”
criticalSupervision / appraisal: “We found no records of staff supervision from the files we sampled. So, it was unclear how the provider was assured that staff were receiving the support they needed.”
criticalConsent / capacity: “Some people's relatives were making decisions on their relative's behalf without the legal authority to do so. Managers understanding of power of attorney and court of protection was not sufficient.”
criticalRecord keeping: “Some staff files sampled did not include details of a full employment history, so gaps in employment had not been explained and risk assessed.”
moderateIncident learning: “Incidents and accidents were recorded, however there were not always checks after the events therefore lessons were not learnt how to avoid events happening again.”
moderatePerson-centred care: “People's diverse needs, including religion, culture, and language, were not assessed as part of the care planning process.”
moderateCommunication with families: “Relatives gave mixed views about being involved in assessing their family member's care, some said they were able to contribute, whereas others said they had not had an opportunity.”
moderateCultural competency: “People's communication care plans did not include information around their first or preferred language. Staff were not matched to meet people's communication needs or preferred language.”
moderateMissed or late visits: “They can be up to two hours late and no one says when they are coming or who, if [relative] rings up it's 'someone will be there'.”
moderateStaff competency: “Staff had received training but did not have a good understanding of best practice models of care. This meant people did not always receive tailored support.”
minorEnd-of-life care: “People's end of life care wishes were not identified as part of their care plan...the care plans did not include any information on how the person wanted this care provided.”
Strengths
· Staff had training on how to recognise and report abuse and knew how to apply it.
· Staff received infection control training and demonstrated understanding of infection prevention measures.
· People and relatives reported care staff were kind, caring and treated people with dignity and respect.
· Some people were supported by consistent care workers who knew their needs well.
· Staff supported people to attend healthcare appointments and undertake exercises to improve mobility.
Quality-Statement breakdown (19)
safe: Staffing and recruitmentInadequate
safe: Using medicines safelyInadequate
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongInadequate
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Mental Capacity Act and consentRequires improvement
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
caring: Ensuring people are well treated and supported; respecting equality and diversityRequires improvement
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and controlRequires improvement
responsive: Meeting people's communication needsRequires improvement
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportRequires improvement
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirementsInadequate
well-led: Continuous learning and improving careInadequate