Brockley, London (Philip's Quality Care Services Limited) was rated Requires Improvement overall at its first inspection, with breaches found in person-centred care (Reg 9), safe care and treatment (Reg 12) and good governance (Reg 17). Risks were not consistently assessed, care plans lacked personalised detail and the registered manager had not embedded audit systems or fully understood regulatory requirements.
Concerns (7)
criticalCare planning — “Both people's records said they were at risk of falls and pressure sores, but there were no specific risk assessments identifying the level of risk and there were no clear written guidelines”
criticalPerson-centred care — “people's care plans included some personalised information about their life histories and personal circumstances, but there was little recorded information about their specific needs and preferences”
criticalGovernance — “The provider was not conducting audits of the care provided. The registered manager did not always demonstrate a good understanding of regulatory requirements”
moderateMedication management — “The provider had a record of which medicines people were taking, but there was insufficient information about whether there were any side effects to these and what they were for.”
moderateLeadership — “the registered manager did not fully understand regulatory issues relating to risk management, which meant he did not identify the issues we found.”
moderateRecord keeping — “people's care records listed their current health conditions as well as the history of their health needs, but there was no recorded information about how these affected people.”
minorOther — “the provider had requested a DBS check from the care worker, but had accepted a check that had been conducted one year ago. This meant the provider could not be sure they had the full history”
Strengths
· Positive feedback from people: 'It's a good service, they treat me with kindness and respect'
· Care worker had received safeguarding and infection control training and understood appropriate procedures
· Appropriate safeguarding, infection control and complaints policies and procedures in place
· Care worker received an effective induction following the principles of the Care Certificate
· Good joint working with other professionals including social workers, GPs and Occupational Therapist
Quality-Statement breakdown (24)
safe: Assessing risk, safety monitoring and managementNot rated
safe: Systems and processes to safeguard people from the risk from abuseNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Supporting people to live healthier lives, access healthcare services and supportNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support, 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 careNot rated
responsive: Meeting people's communication needsNot rated
responsive: Supporting people to develop and maintain relationships and to avoid social isolationNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
well-led: Duty of candour and promoting a positive person-centred cultureNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Continuous learning and improving careNot rated
well-led: Working in partnership with othersNot rated