First inspection of a domiciliary care agency supporting 12 people, rated Good across all five key questions. Recommendations made about risk assessments for restraint (bedrails), with minor issues noted around PRN protocols and PPE use which were addressed during the inspection.
Concerns (4)
moderateCare planning
: “Robust risk assessments were in place for most risks and were reviewed regularly, however we found risk assessments were not in place for the use of restraint.”
minorMedication management: “'When required', or PRN protocols in people's care plans were not always available and did not always include enough information as to when these medicines should be given”
minorInfection control: “Sufficient supplies of PPE were readily available for staff, such as disposable masks, aprons and gloves, however, masks were not always being worn in people's homes.”
minorGovernance: “historically incidents were not notified to the CQC but the service now had systems in place to do so.”
Strengths
· Kind and compassionate care with staff respecting people's privacy and dignity
· Very low staff turnover supporting consistent care
· Safe recruitment with pre-employment checks including references and employment histories
· Effective partnership working with healthcare professionals and the local authority
· Open, transparent culture with an approachable and visible registered manager
Quality-Statement breakdown (24)
safe: Assessing risk, safety monitoring and managementNot rated
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: 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; supporting people to access healthcareNot 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 controlNot rated
responsive: Meeting people's communication needsNot rated
responsive: Supporting people to develop and maintain relationships to avoid social isolationNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Promoting a positive, person-centred, open and empowering cultureNot rated
well-led: Duty of candour and openness when something goes wrongNot rated
well-led: Governance, quality performance, risks and regulatory requirementsNot rated
well-led: Engaging and involving people, the public and staffNot rated
well-led: Working in partnership with othersNot rated