Entirety, a small domiciliary care agency supporting people with learning disabilities and autistic people, was rated Good in all five key questions at this first inspection under the new provider. Minor improvements were noted around recording end-of-life wishes and formally documenting management observations of staff practice.
Concerns (2)
minor
End-of-life care
: “People were not routinely asked about their wishes for the support they wanted to receive at the end of their life.”
minorRecord keeping: “We noted the registered manager did not formally document the outcome of their observations of staff.”
Strengths
· Staff knew people well and understood how to protect them from abuse, with relatives expressing complete trust.
· Personalised, holistic, strengths-based care plans reflecting people's needs and aspirations.
· Staff demonstrated best practice around assessing mental capacity and best interest decision-making.
· Very low staff turnover supporting consistent care from staff who knew people well.
· Effective infection prevention and control measures, including up-to-date policies and food hygiene training.
Quality-Statement breakdown (22)
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; supporting people to access healthcare servicesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supportedGood
caring: Supporting people to express their views and be involved in making decisions about their care; respecting equality and diversityGood
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: Supporting people to develop and maintain relationships and follow interestsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; duty of candourGood
well-led: Engaging and involving people, public and staff; continuous learning and improving care; working in partnership with othersGood