This focused follow-up inspection of Dominion Care Services Limited found the provider had successfully addressed the previous breach of Regulation 19 regarding staff recruitment, improving overall and key question ratings from Requires Improvement to Good. Safe recruitment, risk management, infection control, safeguarding and governance systems were all found to be operating effectively, with only a minor record-keeping lapse noted around undated staff audits.
Concerns (1)
minorRecord keeping: “The provider had carried out audits of staff records. Although these reflected the information we found in staff files, they were not dated.”
Strengths
· Safe recruitment procedures now followed, including verified references, DBS checks, and exploration of employment gaps.
· Risk assessments linked to care plans, regularly reviewed and updated, covering nutrition, mobility, personal care and environmental risks.
· Staff received infection prevention and control training and were supplied with adequate PPE; spot checks of practice carried out.
· Safeguarding policies up to date; staff trained and clear on roles in identifying and reporting concerns.
Dominion Care Services Limited was rated Requires Improvement overall at its first inspection, with a statutory breach of Regulation 19 found due to unsafe staff recruitment practices including incomplete employment histories and duplicated reference forms. While people and relatives reported kind, caring and skilled staff with good outcomes, governance systems failed to identify recruitment and care planning inconsistencies.
Concerns (5)
criticalStaffing levels: “Safe recruitment procedures were not being followed. Application forms did not contain a full employment history.”
criticalRecord keeping: “We found the same written comment on completed reference forms for two staff members which had been sent to two different previous employers.”
moderateGovernance: “The service was not completing any audits of staff records which may have identified the issues we found with staff recruitment.”
moderateCare planning: “Some information about people's risks was not always consistently recorded across their care records and guidance for staff was not always detailed.”
minorInfection control: “People and relatives we spoke to told us staff did not always wear PPE appropriately.”
Strengths
· Staff were skilled, trained and knowledgeable, with induction including shadowing, spot checks and mandatory training
· People and relatives consistently reported kind, caring staff who respected privacy, dignity and independence
· People were supported to access healthcare professionals and maintain a balanced diet
· Consent to care was documented in line with the Mental Capacity Act 2005
· Staff received regular supervision and felt well supported by the registered manager
Quality-Statement breakdown (19)
safe: Staffing and recruitmentRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Preventing and controlling infectionRequires improvement
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuse; Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the law
Good
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
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
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Managers and staff being clear about their roles, and 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 staff; Working in partnership with othersGood
well-led: How the provider understands and acts on the duty of candour; Continuous learning and improving careGood