CAS Care Solutions, a domiciliary care agency in New Milton, was rated overall Good at its first inspection in September 2022, with four of five key questions rated Good. The Well-led domain was rated Requires Improvement due to gaps in record keeping, ineffective audit systems, and unclear medication protocols, including an unmonitored alert for a missed dose.
Concerns (6)
critical
Medication management
: “One person had seizures which may require emergency medication. However, the procedures for administering this were not clear.”
moderateRecord keeping: “We continued to find some gaps in staff and other records. Staff training records were not always clear to show who was providing training to staff.”
moderateMedication management: “An alert was not acted upon when they did not receive their tablet. The provider acknowledged the alert system was not really being monitored.”
moderateGovernance: “Although the provider had an audit system including one for medication, this was not always effective in identifying gaps in records or ensuring areas identified were acted upon.”
minorStaff training: “The induction record did not demonstrate what staff had covered and whether the provider had checked staff knowledge following completion.”
minorIncident learning: “There was no action plan in place at the time of the inspection to indicate what the provider's response had been or would be.”
Strengths
· Positive feedback from relatives, staff and external health professionals about care quality, compassion and professionalism.
· Staff understood safeguarding procedures and were confident appropriate action would be taken if concerns were raised.
· Care workers arrived on time and sufficient staffing levels were maintained; service stopped taking new clients to avoid being overstretched.
· Care plans were detailed, person-centred and included individuals' preferences, routines, cultural and religious requirements.
· Strong partnership working with external health professionals including GPs, occupational therapists and physiotherapists.
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
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
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: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood