Fawaz Homecare Services is a domiciliary care agency providing personal care and support to people in their own homes. The agency is registered to provide care to children and adults including people with a learning disability, people with physical disabilities, people with mental health needs and older adults. At the time of the assessment, only 2 adults were using the service, and no one being supported had a learning disability. The assessment started on 11 July 2024 and ended on 15 July 2024. We conducted this assessment to follow up on concerns we identified at the last inspection. These included breaches of Regulations relating to safe care, person centred care and good governance. The last rating for this service was requires improvement (published 3 August 2022). At this assessment we found improvements had been made and the provider was no longer in breach of any regulations. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. At the time of the inspection, the service did not support people with learning disabilities but they were able to demonstrate how they were meeting all the underpinning principles of right support, right care, right culture.
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First inspection of Fawaz Homecare rated Requires Improvement overall and across all five key questions, with breaches of Regulations 9, 11, 12 and 17 relating to person-centred care, consent, safe care and good governance. Key concerns included unpersonalised template risk assessments, absence of MCA capacity assessments and best interest decisions, and ineffective quality monitoring systems.
Concerns (11)
criticalCare planning: “Risk assessments and mitigation plans were not always detailed or personalised enough to help reduce the risk of avoidable harm to people.”
criticalCare planning: “one person's falls care plan was an example template that had not been changed to reflect the persons' needs and the action taken. This included the wrong name”
criticalConsent / capacity: “the provider did not complete best interest decisions for people who did not have the mental capacity to consent to their care, and that relatives had signed consent forms without the legal authority to do so.”
criticalGovernance: “systems in place to monitor service delivery were not always effective, as they did not always identify the quality of the information input or the areas requiring improvement we identified during the inspection.”
moderateConsent / capacity: “There was no evidence in the training records care workers had completed training around the MCA.”
moderatePerson-centred care: “Care plans did not include details of people's background history and preferences, or people's cultural and religious needs.”
moderateCultural competency: “individual needs such as people's religion and personal history were not recorded in the care plan. This meant care workers did not have guidance to help ensure people received care according to their wishes”
moderateCommunication with families: “Care plans did not have a specific section for information about people's communication needs, for example the language they spoke of if they needed assistive aids such as glasses or a hearing aid.”
moderateStaff competency: “there were instances when they felt some care workers lacked the necessary skill to provide the required level of care to people.”
minorEnd-of-life care: “People's end of life care wishes were not part of the care plan which meant care workers were not provided with guidance on how the person wanted to be supported at that time.”
minorRecord keeping: “Safe recruitment practices were followed but not always recorded correctly, for example gaps in employment history.”
Strengths
· Appropriate safeguarding systems in place and staff completed safeguarding training
· Relatives confirmed care was provided in a safe and caring manner
· Care workers matched with people who spoke their first language
· Safe recruitment procedures including DBS checks were followed
· Infection prevention and control policies, training and PPE were in place
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of 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: 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: 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 and supporting people to access healthcare servicesNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityRequires improvement
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; meeting people's communication needsRequires improvement
responsive: Supporting people to develop and maintain relationships and avoid social isolationNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportRequires improvement
well-led: Continuous learning and improving care; promoting a positive cultureRequires improvement
well-led: How the provider understands and acts on the duty of candourNot 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: Working in partnership with othersNot rated