moderate“The provider's quality assurance checks did not consistently identify shortfalls or recognise how improvements could be made.”
record keeping
1 finding
moderate“risks related to the use of bedrails were not consistently documented within people's care plans. For example, how the risk of entrapment was to be minimised.”
care planning
1 finding
moderate“one person's mobility assessment referenced that they required the support of a hoist. Information was not clear on how staff should safely use a sling when using a hoist.”
consent capacity
1 finding
minor“the mental capacity assessment was not decision specific. We brought this to the attention of the registered manager who took action to address this during the inspection.”
medication management
1 finding
minor“The MAR chart for one person identified that medication should be administered in the morning. Daily notes often referenced that staff were administering the medicine in the afternoon.”