critical“in one person's care plan it stated they had sustained a 'few falls recently'...There was no information or guidance for staff on how to manage this person's risk of falling”
record keeping
1 finding
critical“The provider had failed to fully assess, monitor and mitigate risks within care records relating to the health, safety and welfare of people using the service. This is a breach of Regulation 17”
governance
1 finding
minor“since the recent change of ownership of the service, there had been no formal system implemented to obtain people's feedback”
leadership
1 finding
moderate“At the time of the inspection, there was no registered manager in post.”