Carelife's first inspection rated the domiciliary service Good overall, with Safe rated Requires Improvement due to recruitment procedure shortcomings including a delayed DBS, incomplete employment histories and gaps in topical medication records. People received person-centred, dignified care from staff they trusted, and the registered manager took immediate action to rectify the recruitment concerns identified.
Concerns (8)
critical
Governance
: “The provider did not have a robust recruitment procedure in place.”
criticalRecord keeping: “One of the five staff files we looked at did not have a DBS in place until nine days after they officially started work.”
moderateRecord keeping: “Application forms and employment histories were incomplete and did not always detail specific dates staff worked for previous employers.”
moderateStaff competency: “Where new staff had previously worked in health and social care settings, the provider had not sought satisfactory evidence of conduct in, or the reason staff left their previous employment”
moderateMedication management: “We looked at both records for one month and found there were three dates which had been left blank on both records.”
moderateInfection control: “staff were testing for COVID-19 once a week. At the time of the inspection, national guidance required staff in health and social care settings to complete asymptomatic testing for Covid-19 twice weekly”
moderateLeadership: “The registered manager had not understood the requirements of legislation regarding recruitment procedures and we found staff files did not include all the required information.”
minorIncident learning: “There had not been any incidents recorded where things had gone wrong. The provider was therefore unable to demonstrate any lessons learnt.”
Strengths
· Staff arrived on time and supported people in ways which met their needs and preferences.
· People and their relatives confirmed their privacy and dignity was respected.
· Risk assessments were in place which identified where people were at risk, including healthcare needs and home environment.
· Registered manager liaised with health and social care professionals where necessary.
· Positive feedback from people, relatives and staff about how the service was managed.
Quality-Statement breakdown (24)
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
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 to provide consistent, effective, timely careNot rated
effective: Supporting people to live healthier lives, access healthcare services and supportNot 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 care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot 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