First inspection of newly registered domiciliary care provider rated Requires Improvement overall, with concerns around medication administration records, insufficient detail in risk assessments, and ineffective provider audits/oversight. Staff were caring, well-recruited and knew the person well, with effective, caring and responsive domains rated Good.
Concerns (7)
critical
Medication management
: “Where prescribed creams were being administered, there was no MAR in place to evidence this medication was being administered as prescribed.”
criticalMedication management: “No MAR had been completed to evidence this support.”
moderateCare planning: “Risk assessments were in place which identified the risks staff needed to be aware of in order to support people. However, risk assessments did not contain enough information”
moderateCare planning: “there was not enough detail on how to transfer a person safely.”
moderateGovernance: “The provider's systems and processes for the management and oversight of the service were not consistently effective and had not identified the concerns we found”
moderateGovernance: “Spot checks on staff had not identified where they were not completing medication administration records (MAR) where prescribed creams were being administered.”
moderateStaff competency: “Staff received training and regular competency checks to ensure they were administering medicines safely, however, these checks had not identified where MAR charts were not being completed.”
Strengths
· Staff had received training in safeguarding and knew the actions to take to keep people safe.
· Recruitment processes were in place and recruitment checks were carried out before staff were appointed.
· Staff followed infection control guidance and had access to personal protective equipment.
· People were supported by a regular team of support workers who knew their needs well.
· People were treated with kindness, dignity and respect; privacy and independence were maintained.
Quality-Statement breakdown (24)
safe: Assessing risk, safety monitoring and managementNot rated
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Supporting people to develop and maintain relationships to avoid social isolationNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staff; working in partnership with othersNot rated
well-led: Continuous learning and improving careNot rated