Avon Support Limited received a Good rating across all five key questions at its January 2017 inspection, demonstrating strong person-centred care, safe medicines management, and effective leadership. Minor recording gaps were identified around skin checks, care plan review dates, and formal documentation of staff practice observations, all of which the registered manager committed to address.
Concerns (4)
minor
Record keeping
: “records support workers completed did not show checks were routinely carried out as advised [skin checks]”
minorRecord keeping: “review dates were not always recorded on care plans”
minorGovernance: “observations of staff practice was not recorded as part of the quality monitoring processes”
minorStaff training: “We found one support workers training had not been updated as regularly as other staff.”
Strengths
· People felt safe and staff demonstrated good understanding of safeguarding responsibilities
· Robust medicines management with MAR checks, competency assessments and monthly auditing
· Consistent, familiar support workers enabling trust and person-centred relationships
· Registered manager had extensive MCA knowledge and was working with NICE on MCA guidelines
· Strong person-centred care culture with individualised support plans co-produced with people
Crown Buildings, a small domiciliary care agency supporting 15 people (6 receiving personal care), retained its Good rating across all five key questions at its July 2019 inspection. The service demonstrated consistent, person-centred care with strong leadership, though a minor governance lapse was noted where one safeguarding referral was not submitted to CQC at the time.
Concerns (1)
minorGovernance: “we found one example where the provider had referred a safeguarding concern to the local authority but had not referred to us. The registered manager explained this was an oversight”
Strengths
· People felt safe with care staff and staff understood how to protect people from abuse and poor practice
· Consistent staff teams allocated to the same people, ensuring continuity and familiarity with individual routines and preferences
· Staff received medicines training and observational competency checks to ensure safe administration
· Care plans were personalised and regularly reviewed to remain responsive to individual needs
· Strong leadership with values-based culture described as 'local, person centred and small'
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and managementGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
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 skills, knowledge and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives and access healthcare servicesGood
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 controlGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
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 requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Working in partnership with others; Continuous learning and improving careGood