First inspection of Lanark Care Ealing, a small domiciliary care service supporting four people, rated Good across all five key questions. Inspectors made one recommendation around more thorough record auditing after finding gaps in care plans relating to health needs, medicines support detail and diabetes guidance.
Concerns (6)
moderate
Record keeping
: “the most recent care plans did not have a section on people's health needs. This had been deleted from the previous versions.”
moderateCare planning: “the guidance in the care plan about diabetes was not clear for a care worker to recognise the signs and respond appropriately if a person was having symptoms of high or low blood sugar levels.”
moderateGovernance: “We recommend that thorough audits of all records are carried out regularly to ensure safe and high quality care is provided.”
minorMedication management: “one person's care plan advised staff on how to record the medicines taken but gave no detail on how the person liked to be supported to take their medicines”
minorStaff training: “Staff did not complete the care certificate... although staff had certificates of training in mandatory topics, sometimes several topics were included in one day.”
minorEnd-of-life care: “The service had not provided any end of life care at the time of this inspection and had not asked people about their end of life care preferences.”
Strengths
· Electronic call monitoring system used to ensure calls were on time and not missed
· Safe recruitment practices including DBS, identity and right-to-work checks
· Consistency of care workers matched to the same individuals, often by language and culture
· Cultural and religious preferences (including halal food and language matching) well documented and respected
· Regular monthly contact with people/relatives for quality monitoring and customer surveys
Quality-Statement breakdown (23)
safe: Staffing and recruitmentNot rated
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
effective: Supporting people to live healthier lives, access healthcare services and supportNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Supporting people to develop and maintain relationships and follow interestsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Continuous learning and improving care; Working in partnership with othersNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated