Immediate Medical Solutions Ltd, a small London domiciliary care agency on its first inspection, was rated Good overall with safe, effective, caring and responsive domains all Good. Well-led was rated Requires Improvement due to quality assurance systems not yet fully utilised, lack of community-based staff observations, and the provider remaining registered for an unmaintained transport service not in operation.
Concerns (3)
moderate
Governance
: “quality assurance systems had yet to be fully used to monitor the service and implement continuous improvements.”
moderateStaff competency: “staff had not been observed and checked in their roles out in the community, to ensure they were providing a safe level of care.”
moderateOther: “ambulance vehicle was not suitable and had not been adequately maintained...not maintained to ensure it met all regulatory, infection control and road safety requirements.”
Strengths
· Safeguarding procedures in place; relatives felt family members were safe with staff.
· Sufficient staffing levels with appropriate recruitment and background checks.
· Staff received induction and training covering safeguarding, dementia awareness, MCA, infection control and more.
· Care plans were personalised, including life story, hobbies, interests, outcomes and equality characteristics.
· Positive culture reported by relatives and staff; registered manager described as approachable with open-door policy.
Quality-Statement breakdown (24)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
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 live healthier lives, access healthcare services and support; working with other agenciesGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; 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: 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 requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsGood