ICare Network Ltd, a domiciliary care agency supporting one person at the time, was rated Requires Improvement overall at its first inspection, with breaches of Regulation 12 (safe care and treatment) and Regulation 17 (good governance). Risk assessments, supervision, induction records, recruitment files and quality audits were absent or incomplete, though caring and responsive domains were rated Good with positive relative feedback.
Concerns (7)
criticalGovernance: “The provider had failed to ensure there were effective governance and quality assurance measures in place. This was a breach of regulation 17 (Good governance)”
criticalCare planning: “The registered manager had developed care plan's but they had not always completed and documented how they managed risks. For example, to risk assess the use of bedrails”
moderateSupervision / appraisal: “Staff had not been provided with regular supervision to help support them within their job role.”
moderateStaff training: “there were no records available to show whether staff had been supplied with suitable induction.”
moderateInfection control: “the registered manager had not routinely recorded testing and had no evidence of general oversite and monitoring of staff testing and their results.”
moderateRecord keeping: “Some of the care records had not been fully documented and signed. Some improvements were needed with the care records to help improve the accuracy and clarity of the support plans.”
minorOther: “Staff recruitment procedures needed improvements to ensure they had all relevant documentation to evidence safe recruitment practices. For example, interview notes had not been stored”
Strengths
· Relatives reported positive caring experiences and confidence in staff
· Care plans reflected people's choices and diverse needs
· Staff were knowledgeable about safeguarding procedures
· Staff followed infection control procedures and had access to plenty of PPE
· Service worked in partnership with external agencies and professionals
Quality-Statement breakdown (18)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Preventing and controlling infectionRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
effective: Staff working with other agencies; supporting healthier lives and nutritionNot rated
caring: Ensuring people are well treated and supported; respecting equality, dignity and independenceGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: Planning personalised care; End of life care and supportGood
responsive: Meeting people's communication needsNot rated
responsive: Supporting people to develop and maintain relationships and follow interestsNot rated
well-led: Managers and staff being clear about roles; understanding quality, risks and regulatory requirements; Continuous learningRequires improvement
well-led: Promoting a positive person-centred culture; engaging people, public and staff; partnership workingNot rated
well-led: How the provider understands and acts on the duty of candourNot rated