Recruit4care's first CQC inspection found multiple regulatory breaches across safe recruitment, risk assessment, medicines management, Mental Capacity Act compliance and governance, resulting in a Requires Improvement overall rating. Despite staff being consistently praised for their caring approach, the absence of formal quality assurance systems, incomplete care planning and poor record keeping placed people at risk of harm.
Concerns (9)
criticalStaffing levels: “Missing information included full employment history, health declaration and satisfactory conduct evidence from current or previous employers.”
criticalMedication management: “No medicines administration records were in place, which is a legal requirement, to record what time medicines should be given and when they had been administered.”
criticalCare planning: “People's needs were not formally documented prior to receiving a service...information about how staff should meet people's needs, was not sufficiently detailed within people's care plans.”
criticalConsent / capacity: “There was no information within people's care plans to demonstrate their ability to understand and agree to the planned care.”
criticalGovernance: “Formal systems to monitor the quality and safety of care delivered were not in place. There were no audits to enable effective oversight of the service.”
criticalSafeguarding: “The failure to ensure all recruitment checks and risk assessments were completed meant people could be at risk of harm.”
moderateRecord keeping: “Record keeping was poor and records were not always available. The provider had failed to ensure information captured about people's needs, was accurate and sufficiently detailed.”
moderateSupervision / appraisal: “Staff told us they felt supported...although formal recorded supervision had not been undertaken.”
moderatePerson-centred care: “There was limited information about people's health needs...no information about people's personal histories, social interests or preferences.”
Strengths
· People and family members consistently praised staff as kind, caring and respectful of dignity and privacy.
· Staff had completed required training including moving and handling, infection control, medicines and safeguarding.
· People received support from a regular, consistent staff team who knew them well.
· Staff understood safeguarding responsibilities and knew how to escalate concerns.
· Appropriate PPE was used and infection prevention and control training was completed by all staff.
Quality-Statement breakdown (22)
safe: Staffing and recruitmentRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Supporting people to live healthier lives, access healthcare services and supportRequires improvement
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
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 preferencesRequires improvement
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: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood