Welcome Home improved from Requires Improvement to Good across all three inspected key questions (Safe, Effective, Well-led), with previous shortfalls in medicines management, care planning, MCA recording and staff training successfully addressed. Minor areas for ongoing attention include the consistency of formal staff supervisions, MCA documentation, and punctuality of domiciliary care visits.
Concerns (3)
minorSupervision / appraisal: “formal supervisions were not always as frequent as expected. The provider was working towards make improvements in this area.”
minorConsent / capacity
: “there was some inconsistency in how these conversations and decisions were recorded. Immediate action was taken to ensure staff followed best practice around assessing mental capacity”
minorMissed or late visits: “10% of people responded that staff did not always arrive on time and their concerns were not always responded to. A plan of action had been put in place”
Strengths
· People and relatives gave consistently positive feedback about the quality, safety and continuity of care provided.
· Medication management had been significantly improved since the last inspection, with PRN guidance, body charts for pain patches, and regular competency checks in place.
· Staffing levels and recruitment processes were robust, with comprehensive DBS checks, references and induction training.
· Risk assessments were thorough, up-to-date and accessible to staff, supporting safe care delivery.
· Safeguarding knowledge was strong; staff confident in reporting concerns internally and to external agencies.
Welcome Home (DCA service, locationId 1-107292415) was rated Requires Improvement overall at its September 2016 inspection, with six regulatory breaches spanning medicines management, risk assessment, recruitment, supervision, consent/MCA, and governance — none of which had been remedied since the previous August 2015 inspection. Caring and Responsive were rated Good, reflecting positive feedback from people and relatives and person-centred practices, but systemic leadership and governance failures left safety and quality monitoring critically deficient across both the care home and DCA service.
Concerns (18)
criticalMedication management: “the medication administration records (MAR) in the care home did not always confirm that people received the medicines as prescribed. Three people's MAR charts we looked at showed gaps”
criticalCare planning: “mental capacity assessments had not been undertaken with people living in the care home before care planning decisions had been made.”
criticalConsent / capacity: “There was no evidence of best interest's decisions within the care home to make sure people's rights were upheld.”
criticalConsent / capacity: “best interests meeting had taken place in July 2009 and there was no evidence the decision had been reviewed since then.”
criticalSupervision / appraisal: “In the care home there were no written records to show that regular supervision had been undertaken with staff.”
criticalGovernance: “quality monitoring documentation we asked to see such as medicines audits, care plan audits and people's personal finance audits were not available.”
criticalGovernance: “quality assurance and governance systems were not in place to enable the provider to drive continuous improvement at the service.”
moderateMedication management: “We found no protocols in place for 'as and when necessary' (PRN) medicines within the DCA service records.”
moderateRecord keeping: “gaps in people's MAR charts where staff had not signed to say they had given people their prescribed medicines.”
moderateSupervision / appraisal: “three staff had only one supervision meeting in the last 12 months, one had no observation checks and three had either one or two observation checks”
moderateStaff training: “There was no evidence of new staff receiving induction training, which provided them with essential information about their duties and job roles.”
moderateRecord keeping: “Improvements were needed around record keeping to ensure that all information was available and up to date to make sure people received safe care.”
moderateSafeguarding: “A safeguarding procedure or a copy of the local authority safeguarding protocols were not available for staff to refer to in the care home.”
moderateStaff competency: “The registered manager had not had the correct level of training required to ensure the care home was working within the principles of the Mental Capacity Act 2005.”
moderateLeadership: “The provider did not ensure the registered manager had the support necessary to make the improvements expected following the previous comprehensive inspection.”
minorComplaints handling: “verbal complaints were not recorded as complaints and therefore not analysed in order to learn from mistakes and make improvements to service delivery.”
minorMissed or late visits: “The time I requested was 08:30 but they do not come at that time and it has got later and later.”
minorOther: “The registered provider failed to display the rating of their previous comprehensive inspection at the premises where the service was provided.”
Strengths
· People and their relatives were very positive about the care and support received, describing staff as kind, caring and respectful.
· Sufficient staffing numbers in both the care home and DCA service, with arrangements for short-notice cover.
· Person-centred care plans in the DCA service with regular reviews every six to eight weeks involving people and their relatives.
· Close liaison with health and social care professionals to maintain people's health and wellbeing in both services.
· New electronic recording system in the DCA service improved communication, accuracy and efficiency.
Quality-Statement breakdown (20)
safe: Risk assessment and managementRequires improvement
safe: Medicines administration and recordingRequires improvement
Welcome Home (DCA and care home) received a Requires Improvement overall rating, with Inadequate for well-led, due to persistent breaches across governance, medicines management, staff training and supervision, and Mental Capacity Act compliance in the care home that remained unresolved from the previous inspection. The care agency showed meaningful improvement in medicines management, risk assessment, care planning and use of electronic recording, while the care home continued to present multiple regulatory breaches requiring enforcement action.
Concerns (10)
criticalMedication management: “The period between 12 November 2016 and 06 March 2017 no records had been made. Between 15 May 2017 and 31 May 2017 and from 31 May 2017 to 22 June 2017 no records had been made.”
criticalStaff training: “Out of 17 staff working in the care home, only 12 staff had updated safeguarding adults training, seven had completed first aid training, nine staff had undertaken fire training.”
criticalSupervision / appraisal: “Two had no supervision meetings documented and four had one supervision meeting in December 2016 and none since.”
criticalConsent / capacity: “There continued to be no records of best interests meetings having taken place when less complex decisions needed to be made on people's behalf.”
criticalGovernance: “Quality monitoring systems had not been developed to ensure the registered provider and the registered manager had proper oversight of the quality and safety of either service.”
criticalLeadership: “The provider continued to have very little involvement in either the day to day management or the strategic direction of the service.”
moderateCare planning: “Some care plans had not been fully reviewed since October 2015. There was no record that other people involved in the person's life had attended to review the care plan.”
moderateRecord keeping: “Records continued to not be kept up to date or recorded consistently to avoid errors or omissions. Systems and processes were not in place to identify concerns.”
moderateIncident learning: “Although some audits had been carried out since the last inspection, these were sporadic, and had not continued and no actions had been identified to improve the service.”
minorPerson-centred care: “Individual activity plans or a care plan focusing on people's interests and activities to make sure people were always supported to have meaningful activity each day were not in place.”
Strengths
· Medicines management had improved in the care agency with effective use of the electronic recording system including live alerts and medicines competency assessments.
· Risk assessments in the care agency were reviewed regularly and environmental risks were assessed at initial assessment stage.
· Safe recruitment practices were now in place in both the care home and the care agency, including DBS checks and reference verification.
· Staff understood their safeguarding responsibilities and knew how to report concerns internally and externally.
· People and relatives were positive about staff, describing them as caring, kind, and person centred.
Quality-Statement breakdown (24)
safe: Risk assessment and review (care home)Requires improvement
safe: Medicines management (care home)Requires improvement
safe: Medicines management (care agency)Good
safe: Risk assessment and review (care agency)Good
safe: Staffing levels and recruitmentGood
safe: SafeguardingGood
effective: Staff training (care home)Requires improvement
effective: Staff supervision and appraisal (care home)Requires improvement
Welcome Home (KLOE inspection, May 2019) was rated Requires Improvement overall with Well-Led rated Inadequate, representing the fifth consecutive sub-Good rating and resulting in a warning notice for breach of Regulation 17. Critical failures centred on ineffective governance and audit systems, outdated staff training for epilepsy, diabetes and PEG care, non-compliant Mental Capacity Act and DoLS processes, and inadequate recruitment checks including DBS checks dating back to 2009.
Concerns (11)
criticalRecord keeping: “Risk assessments did not address identified risks to people, nor provide plans to mitigate the risk. Risk assessments were confusing as they covered many areas within one assessment.”
criticalStaff training: “No staff had up to date epilepsy training. The last time any staff had undertaken epilepsy training had been in 2016... Six staff had not completed the training at all.”
criticalStaff competency: “No staff in either the care home or the care agency had completed a practical moving and handling training course or had their practical skills tested.”
criticalConsent / capacity: “The registered manager was unclear how many people had a DoLS authorisation in place... The other person's DoLS authorisation had expired in November 2018.”
criticalGovernance: “Weekly audits to check the quality and accuracy of the care agency records had not been sustained. The first audit was undertaken in December 2018. Following this, no further audits had taken place until 25 April 2019.”
criticalSafeguarding: “Robust recruitment procedures had not been followed to make sure only suitable staff were employed... One staff member had not had an updated DBS check since 2009.”
criticalLeadership: “The provider and registered manager had not been able to achieve a Good rating over five CQC inspections.”
moderateCare planning: “Care plans in place did not identify known triggers that may cause people to challenge. Nor did they describe what the behaviour may be communicating to staff.”
moderateCommunication with families: “The provider had not sought feedback from the relatives, friends or other stakeholders of people living in the care home to gain their views of the service provided.”
minorMissed or late visits: “Many people we spoke with said staff often turned up late. This meant people were kept waiting to receive their care. This is an area that needs improvement.”
minorPerson-centred care: “Although people clearly liked to do these things, there was no evidence... about new things that had been tried to increase people's choices. People had been taking part in the same activities for many years.”
Strengths
· Medicines were managed safely; people received medicines on time and as prescribed with complete administration records and no gaps or errors.
· Staff across both services knew people well and supported them with dignity and respect, using individual communication methods.
· People using the care agency reported feeling safe and praised staff as caring, friendly, competent and professional.
· People were supported to access healthcare including dentists, chiropodists, opticians and annual GP health checks.
· Complaints and concerns raised to the care agency were acted on promptly and to the satisfaction of those who raised them.
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
Welcome Home, a combined care home and domiciliary care agency, was rated Requires Improvement overall (Inadequate for well-led) at this November 2019 inspection, remaining in special measures due to continued breaches of Regulations 12, 17 and 18. Key failures centred on unsafe staffing levels and missed/late visits in the care agency, poor medicines management, ineffective governance and monitoring systems, and inadequate record keeping, despite some improvements to staff training and care home risk assessments since the previous inspection.
Concerns (9)
criticalRecord keeping: “Many records showed shorter visit times than people were allocated. One person had two visits one day recorded as seven minutes and nine minutes.”
criticalStaffing levels: “Last Sunday only one carer turned up, when there should have been two carers. This has happened two to three times recently.”
criticalMedication management: “In August, September and October 2019 the person ran out of their medicines and missed one to two days of their medicines as they had not been ordered in time.”
criticalGovernance: “The monitoring systems used in the care agency were not effective in maintaining quality standards... concerns we found had not been identified or actioned.”
moderateMissed or late visits: “Morning care visits varied between 6.30am and 8.40am with no explanations why the visit times changed.”
moderateCare planning: “One person had a catheter in place yet a risk assessment and management plan was not recorded to provide guidance for staff.”
moderateComplaints handling: “Not all of these were logged as complaints which meant a robust system was not in place to make sure lessons were learnt from complaints.”
moderateConsent / capacity: “How a decision was reached and evidence to show the decision was in the person's best interest had not been clearly recorded.”
moderateLeadership: “Although the registered manager was aware this was the case and some staff were not fulfilling their role, there was no evidence they had addressed this.”
Strengths
· Staff knew people well and were able to describe individual needs, preferences and how to support them safely.
· People felt safe with staff and gave positive feedback about their kindness, gentleness and person-centred approach.
· Improvements made to staff training including accredited moving and handling, epilepsy and diabetes awareness.
· Staff received regular one-to-one supervision and had the opportunity to complete the Care Certificate.
· Medicines were managed safely in the care home with no gaps or errors in administration records.
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and management; Preventing and controlling infectionRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Staff support: induction, training, skills and experienceGood
effective: Adapting service, design, decoration to meet people's needs
Welcome Home (dual registered care home and domiciliary care agency) was rated Requires Improvement overall at its April 2021 inspection, having exited Special Measures after resolving three prior regulatory breaches. Improvements were evidenced across all five key questions, but ongoing concerns about late and missed care visits, incomplete care records and assessments, outstanding staff refresher training, and the need to embed and sustain governance improvements prevented a Good rating.
Concerns (7)
criticalInfection control: “We were not assured the provider and registered manager were promoting safety through the layout and hygiene practices of the premises.”
moderateMissed or late visits: “They are supposed to come at half past nine, but it can be after eleven o'clock. They didn't come at all last night.”
moderateCare planning: “Some people's assessments were not complete. Some information was missing. For example, a section entitled, 'What is important to me' was not completed.”
minorRecord keeping: “Some staff had not always been completing an accurate record of the times of visits on one of the systems.”
minorMedication management: “Guidance was not in place to inform staff to rotate the areas of the body where the patch was placed to avoid skin irritation.”
minorGovernance: “Some action points had been carried over from one month to the next in the care home maintenance audits. An explanation wasn't given why there was a delay.”
minorStaff training: “Some refresher courses had not been completed by some staff, such as diabetes awareness and catheter care.”
Strengths
· Staff were caring, kind and respectful; relatives described people as very happy and considered the care home their true home.
· Safeguarding training was up to date and staff demonstrated confidence and knowledge in recognising and reporting abuse.
· Medicines administration in the care home was safe, with individual safes, stock checks and competency assessments in place.
· Infection prevention and control improved to full compliance following a warning notice, with all IPC assurance criteria met.
· Complaints handling improved with written responses now provided and outcomes relayed to complainants.
Quality-Statement breakdown (24)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyRequires improvement
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
safe: Systems and processes to safeguard people from the risk of abuseGood
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
Welcome Home received an overall rating of Requires Improvement following a March 2018 inspection, with three continued regulatory breaches under Regulations 12, 17 and 18 relating to unsafe medicines management in the care agency, inadequate governance and quality monitoring systems, and insufficient staff supervision and training. The care home's caring practice was rated Good, with staff knowing people well and relatives highly satisfied, but systemic management weaknesses in the care agency—including poor staffing coordination, outdated care plans and absent incident investigation—remained unresolved since the previous enforcement action in June 2017.
Concerns (14)
criticalMedication management: “People's prescribed medicines were not always managed safely in the care agency. Incidents had not always been investigated appropriately to ensure action was taken to avoid similar incidents.”
criticalMedication management: “An incident had occurred on Tuesday 20 March 2018 when a member of staff noted from the MAR that the previous days medicines had not been administered... two reportable incidents had occurred.”
criticalSupervision / appraisal: “Of the five staff files we looked at in the care home... one staff member had received no supervision, one staff had one supervision meeting recorded. Staff had still not had the opportunity to take part in an annual appraisal.”
criticalStaff training: “Out of 20 staff, only three staff had completed dementia awareness training even though staff supported people living with dementia in their own homes; three staff had undertaken health and safety training.”
criticalGovernance: “Consistent auditing systems to ensure the clear management and oversight of the service by the provider and registered manager had not yet been evidenced.”
criticalIncident learning: “The office staff did complete an incident form, however, no further investigation had been carried out by the care agency manager or the registered manager.”
criticalRecord keeping: “The failure to ensure records were kept up to date, to have systems in place to manage the service successfully and to regularly assess and monitor the quality of the service is a continued breach of Regulation 17.”
Strengths
· People living in the care home were happy, relaxed and well cared for, with relatives overwhelmingly positive about care quality.
· Medicines administration in the care home had improved significantly since the last inspection, with daily audits and competency checks in place.
· Safe and robust staff recruitment procedures were maintained across both services.
· Person-centred care plans in the care home contained detailed, individualised information including communication preferences and end of life plans.
· Staff knew people well, supported independence, and maintained dignity and privacy during personal care.
Quality-Statement breakdown (24)
safe: Risk assessment and mitigation (care home)Requires improvement
safe: Medicines management (care agency)Requires improvement
safe: Medicines management (care home)Good
safe: Staffing deployment (care agency)Requires improvement
safe: Staff recruitmentGood
safe: Safeguarding awarenessGood
effective: Staff supervision and appraisalRequires improvement
Welcome Home received a targeted IPC inspection in December 2020 resulting in a breach of Regulation 12 (Safe care and treatment) due to unsafe laundry facilities, absent cleaning schedules, unsafe infectious waste disposal, and inconsistent PPE use. A notice to comply was served on both the provider and registered manager, with the overall and safe ratings recorded as inspected but not rated.
Concerns (3)
criticalInfection control: “The laundry room was in a poor state of repair and cleanliness. Cracked and chipped concrete flooring was clearly visible...No handwashing facilities were available for staff.”
criticalInfection control: “A planned cleaning schedule was not in place for staff to clean high touch areas regularly throughout the day and night, such as lights switches and door handles.”
criticalInfection control: “Staff were not using consistent practice when putting on and taking off their PPE...where this was kept to ensure safe use when providing individual care had not been carefully planned.”
Strengths
· Service was generally clean and domestic cleaner carried out deep cleaning in communal areas.
· Staff supported people well to socially distance and isolate in their rooms by spending more one to one time providing activities.
· The service had enough PPE to meet current and future demand.
· Provider was preventing visitors from catching and spreading infections.
· Provider was meeting shielding and social distancing rules.
Quality-Statement breakdown (1)
safe: How well are people protected by the prevention and control of infection?Insufficient evidence to rate
Welcome Home's DCA (and combined care home) was rated Requires Improvement following an August 2015 unannounced inspection triggered by concerns about recruitment, training, missed visits and records. Multiple regulatory breaches were found across safe recruitment (Reg 19), medicines (Reg 12), risk assessment (Reg 12), supervision (Reg 18) and governance (Reg 17), though caring was rated Good with staff consistently praised for kindness and person-centred support.
Concerns (10)
criticalMedication management: “The medication administration records (MAR) did not always confirm that people received the medicines as prescribed. For one person there were gaps in the recording of medicines administered.”
criticalSupervision / appraisal: “Staff told us that they had not had regular individual one to one meetings for some time. There were no written records to show that regular supervision had been undertaken.”
criticalGovernance: “Quality assurance and governance systems were not in place and had not been used to drive continuous improvement at the service.”
criticalStaff competency: “A full employment history had not always been obtained for five staff. There were no interview records, and no evidence that any gaps in employment on the application form had been followed up.”
moderateRecord keeping: “The medicine cabinet temperature and medicine fridge temperature had not been recorded every day.”
moderateStaff training: “Some staff in the care home needed to refresh training in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).”
moderateCare planning: “Five people's records showed that they had not had a review since May 2015.”
moderateRecord keeping: “The Statement of Purpose for the services had not been kept under review since April 2012. Information contained in the Statement of Purpose was not up to date.”
moderateMissed or late visits: “The registered manager was unable to find a record of any missed calls to people in the community. The registered manager said that there had been an occasional missed call.”
minorSafeguarding: “Some of the information about who to contact was not up to date. For example, information about who to contact together with names, addresses and telephone numbers.”
Strengths
· Staff treated people with dignity and respect, with a calm and welcoming atmosphere observed in the care home.
· People and relatives gave consistently positive feedback about the kindness and caring approach of staff in both the care home and DCA.
· Sufficient staffing levels were maintained with arrangements in place to cover sickness at short notice.
· Accidents and incidents were recorded, monitored and reviewed by the registered manager to prevent future occurrences.
· Staff understood safeguarding responsibilities and knew how to report concerns to the local authority safeguarding team.
well-led: Quality assurance and governance systemsRequires improvement
well-led: Record keeping and documentationRequires improvement
well-led: Leadership and management oversightRequires improvement
well-led: Staff culture and engagementGood
effective: Staff supervision and appraisal (care agency)Requires improvement
effective: Mental Capacity Act compliance (care home)Requires improvement
effective: Healthcare professional involvementGood
effective: Nutrition and hydrationGood
caring: Relationships and staff interactionsGood
caring: Dignity, respect and independenceGood
caring: Involvement in care planningGood
responsive: Care plan review (care home)Requires improvement
responsive: Care plan review (care agency)Good
responsive: Activities and meaningful occupation (care home)Requires improvement
responsive: Complaints handlingGood
well-led: Governance and quality monitoringInadequate
well-led: Record keepingInadequate
well-led: Provider oversightInadequate
well-led: Staff culture and satisfactionGood
well-led: Electronic recording system (care agency)Good
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
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
caring: Ensuring people are well treated and supported; 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 meet people's needs, preferences, interests and give them choice and controlRequires improvement
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsInadequate
well-led: Continuous learning and improving careInadequate
well-led: Engaging and involving people using the service, the public and staffRequires improvement
well-led: Planning and promoting person-centred, high-quality care and supportRequires improvement
well-led: Working in partnership with othersRequires improvement
Requires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
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 careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Supporting people to develop and maintain relationships to avoid social isolation; support to follow interestsRequires improvement
responsive: Improving care quality in response to complaints or concernsRequires improvement
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirementsInadequate
well-led: Engaging and involving people using the service, the public and staffRequires improvement
well-led: Working in partnership with othersRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement
effective: Adapting service, design, decoration to meet people's needsRequires improvement
effective: Staff support: induction, training, skills and experienceRequires improvement
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
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Working in partnership with othersGood
moderateCare planning: “Care plan reviews should have been carried out every 10 - 12 weeks, however, one person had not had a review of their care plan since September 2017 and another since October 2017.”
moderateCare planning: “Although changes to people's care and support needs were recorded each month, the changes were not always reflected in the care plan.”
moderateGovernance: “Weekly health and safety checks had not been completed in the care home since 30 January 2018. One member of staff was responsible... but had not been available and the registered manager had not allocated the task.”
moderateStaffing levels: “Staff changes had meant the care agency management team could not always deploy staff appropriately... 'No, I don't think they have enough staff to go round so everything is rushed.'”
moderateConsent / capacity: “A mental capacity assessment had not been undertaken to determine if the person had the capacity to consent to the restriction [bed guard], or evidence of the decision having been made in the person's best interests.”
moderateLeadership: “People who received care and support from the care agency and their relatives told us clearly they did not think the service was managed well.”
moderateCommunication with families: “'The problem is the office and they never keep us up to date with changes'; 'No continuity at all, none whatsoever. Nothing is ever followed through and notes are never passed from one person to another.'”
effective: Mental Capacity Act compliance (care home)Requires improvement
effective: Care needs assessment and care planningGood
effective: Access to healthcare professionalsGood
effective: Nutrition and hydration supportGood
caring: Relationships between staff and peopleGood
caring: Dignity, respect and independenceGood
caring: Involvement in care planningGood
responsive: Person-centred care planningGood
responsive: Care plan review and updatingRequires improvement
responsive: Community activities and interests (care home)Good
responsive: Complaints handlingGood
well-led: Quality monitoring and governance systemsRequires improvement
well-led: Record keepingRequires improvement
well-led: Staff meetings and team cultureRequires improvement
well-led: Provider oversight and leadership (care agency)Requires improvement
well-led: Staff feedback and engagementRequires improvement
effective: Nutrition and hydration
Good
caring: Dignity, respect and privacyGood
caring: Involvement in care decisionsGood
responsive: Care planning and review (DCA)Requires improvement
responsive: Complaints handlingGood
responsive: Activities and person-centred support (care home)Good
well-led: Quality assurance and governanceRequires improvement