CSK Support 24 Ltd Northampton domiciliary care agency registered to provide personal care. We carried out our site assessment on 19 March 2024 and finished the assessment on 26 March 2024. The assessment was carried out due to concerns with monitoring whether calls had been carried out. We found there had been improvements in this area during the assessment and this was no longer a concern We looked at eight quality statements: [Safeguarding, Involving people to manage risk, Safe and effective staffing, Medicines Optimisation, Person-Centred Care, Listening to and involving people, Kindness compassion and dignity and Governance, management and sustainability]. At our last inspection the service was rated requires improvement. At this assessment we found the provider had made some improvements to meet the regulations. However, further action was required. The service rating remains requires improvement. At our last inspection the service was in breach of the regulations around safe care and treatment due concerns seen in managing medicines. There was improvement in this area and the service was no longer in breach of this regulation. However, we identified a new breach around governance as systems and processes had not identified some of the issues we saw during the assessment.
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CSK Support 24 Ltd Northampton deteriorated from Good to Requires Improvement, with a regulatory breach of Regulation 12 identified due to incomplete risk mitigation strategies, poor PRN medicines recording, and inconsistent call times. Governance and audit systems failed to identify key concerns around record keeping, call timeliness, and complaints management.
Concerns (6)
criticalCare planning: “Not all people had detailed risk assessments in place. For example, risk assessments which did not contain all the potential and known risks for one person who smoked and used emollient creams”
criticalMedication management: “Staff did not record the reason for administering a medicine prescribed on an 'as required basis' to manage a person's distress or pain.”
moderateMissed or late visits: “Due to staff being late I don't always have my tablets at the right times. Sometimes they don't have time to do you a dinner, so it has to be something quick.”
moderateRecord keeping: “Staff had not recorded checking water temperature for one person or skin pressure damage checks for three people.”
moderateGovernance: “Audits completed had not identified concerns found on inspection. Audits were not completed on call times.”
moderateComplaints handling: “One relative told us their recent complaint had not been dealt with to their satisfaction and communication with management had been lacking. This complaint was not documented on the complaints log.”
Strengths
· Staff were recruited safely with necessary checks including references and DBS completed.
· People were protected from abuse; staff understood safeguarding procedures and knew signs of abuse.
· Staff were regularly tested for COVID-19 and had sufficient PPE with infection prevention and control training.
· Incidents and accidents were recorded and audited by the registered manager for trends and patterns.
· People and relatives were involved in the care planning process and signed documents to evidence agreement.
CSK Support 24 Ltd Northampton received a Good rating across all five key questions at its first CQC inspection in October 2020, demonstrating safe, person-centred care delivered by a well-trained and consistently deployed staff team. Minor improvements were required to staff rota accuracy and staff meeting record-keeping, both of which the registered manager addressed promptly during and after the inspection.
Concerns (2)
minorRecord keeping: “Staff rotas were not always effective in accurately planning people's care. One person's morning call was scheduled for 10:00 but was consistently taking place around 06:00.”
minorGovernance: “There was no section within the staff meeting records to show what issues staff had raised and who was responsible for addressing and resolving these issues and by when.”
Strengths
· People felt safe and staff were trained in safeguarding procedures with clear guidance on protecting people from abuse and neglect.
· Electronic MAR charts and real-time monitoring system enabled accurate medicines administration and timely oversight by care co-ordinators.
· Comprehensive induction including Care Certificate, regular supervisions, competency checks and annual reviews ensured skilled and supported workforce.
· Person-centred care plans contained in-depth information about people's preferences, life history, routines and end of life wishes in line with Gold Standards Framework.
· Strong infection prevention and control practices with appropriate PPE available and a Covid-19 policy implemented.