Your Life (Cheltenham) requires improvement overall due to gaps in staffing levels, insufficient detail in care plans, and inadequate medication guidance for topical treatments. The service performed well in caring and effective domains, with compassionate, qualified staff and positive person-centred relationships.
Concerns (5)
moderate
Staffing levels
: “There were 10 occasions when a duty manager was the only member of staff on duty.”
moderateMedication management: “One of the ointments was prescribed for a specific area of one leg and if used elsewhere could cause irritation. This level of detail was not in the person's care plan.”
moderateCare planning: “One person told us the staff put their commode by their bed when they went to bed...None of this was in the person's care plan.”
minorComplaints handling: “One person said, 'It can take a while for things to be sorted out' and another said 'You can mention something and no-one comes back to you about it'.”
minorRecord keeping: “Care plans needed some improvement to make them more specific and relevant to the person's needs.”
Strengths
· People felt safe and trusted staff: 'I completely trust the girls' and 'I feel absolutely safe and secure here'
· Robust recruitment processes including DBS checks, references and employment history verification
· Staff had relevant qualifications; all care staff held NVQ-level national qualifications in care
· People received care for their full expected visit time and were notified when staff were running late
· Person-centred care delivery: 'My care is fully personalised to my needs and preferences'
Your Life (Cheltenham) achieved a Good rating across all five key questions at this January 2020 inspection, maintaining its previous 2017 rating. The service demonstrated consistently safe, person-centred care with strong leadership, effective quality assurance systems, and positive feedback from people and relatives.
Strengths
· People and relatives consistently praised the kind, compassionate and respectful approach of staff.
· Robust medication management with annual competency assessments and accurately completed MAR records.
· Consistent staffing team with strong knowledge of individual people's needs and preferences.
· Effective quality assurance systems including twice-yearly surveys, care plan audits and medicine checks.
· Strong safeguarding culture with staff confident to raise concerns and whistle-blow.
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Staffing and recruitmentGood
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
Your Life (Cheltenham) achieved a Good rating across all five key questions at its July 2017 inspection, demonstrating sustained improvement from the previous Requires Improvement rating in March 2016. The service was characterised by personalised, dignified care, a capable and well-regarded registered manager, and effective governance systems that identified and addressed shortfalls.
Strengths
· People felt safe and reported consistent, timely care visits with staff spending expected time with them
· Staff had clear safeguarding knowledge and understood reporting responsibilities including escalation to local authority
· Medicines administration was well managed with consistently maintained records and trained staff
· Personalised care plans were thoroughly assessed, regularly reviewed, and co-produced with people
· Strong continuity of care with regular carers enabling positive relationships and familiarity
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and controlGood
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: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Continuous learning and improving careGood