Care and Protect UK is a small domiciliary care agency rated Good overall at its first inspection in July 2019, with strong person-centred care, safe medicines management and no missed visits reported. Well-led was rated Requires Improvement due to the registered manager's dual care-delivery and oversight role creating a conflict of interest in quality auditing, and a gap in financial audit arrangements.
Concerns (4)
moderate
Governance
— “no audit had been completed regarding the handling of one person's finances. We spoke to the registered manager regarding this and they agreed to implement this audit with immediate effect.”
moderateLeadership — “the registered manager provided care, they were in effect checking their own work for quality purposes.”
minorEnd-of-life care — “Staff had not been trained in end of life care...Care plans did not include any information regarding people's end of life wishes.”
minorRecord keeping — “one staff file did not contain a full employment history. We spoke to the registered manager regarding this and they took steps to introduce appropriate checks.”
Strengths
· People felt safe and reported staff were always on time with no missed visits.
· Medicines were managed safely with regular competency checks by the registered manager.
· Staff received safeguarding training and were confident in their knowledge and actions.
· Care plans were detailed, person-centred, and included individual risk assessments.
· The registered manager carried out face-to-face needs assessments prior to care commencing.
Quality-Statement breakdown (23)
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: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
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 control and to meet their needs and preferencesGood
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 requirementsRequires 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: Continuous learning and improving careGood
Care and Protect UK received an overall Good rating following a focused remote inspection of Safe and Well-Led domains, with the Well-Led rating improving from Requires Improvement at the previous inspection. A minor recommendation was made regarding recruitment practices after safe recruitment procedures were not fully followed for a volunteer, though no impact on people's care was identified.
Concerns (1)
minorOther — “Safe recruitment practices had not been followed in relation to a volunteer. There had been no contact with people using the service and no impact on care.”
Strengths
· Sufficient staffing levels with no missed calls; people confirmed staff arrived on time and stayed the required duration
· Medicines managed safely with regular staff training and competency assessments
· Detailed risk assessments and care plans developed and reviewed routinely, with relatives involved in care planning
· Positive, open culture with registered manager providing direct care and leading by example
· Improvements made since last inspection: staffing rota revised and independent auditor introduced for records review
Quality-Statement breakdown (11)
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empowering
Good
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people; continuous learning and improving careGood