Date of assessment: 15 January 2025. This service is a domiciliary care agency. It provides personal care to people living in their own homes. At the time of our assessment, 3 people were receiving support with personal care. The service provides support for younger and older adults. Most people using the service were older adults. The provider was previously in breach of the legal regulations in relation to management of medicines, assessing risk and good governance. Improvements were found at this assessment and the provider was no longer in breach of this regulations. We 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. People were protected and kept safe through the management of possible risks and the investigation of incidents. Care workers completed a range of training, undertook regular supervision meetings, team meeting and annual appraisals. There were enough care workers with the right skills, qualifications and experience. Care workers managed people’s medicines safely. The provider had developed a range of quality assurance processes. Staff felt they were supported by the registered manager and confident to raise any concerns they may have. The service had identified core values and a business strategy.
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run npm run etl:reports -- --location 1-10821356131.
First inspection of newly registered domiciliary care service rated Requires Improvement overall, with breaches of Regulation 12 (safe care and treatment) for medicines guidance and risk management, and Regulation 17 (good governance) for inadequate quality assurance. Effective, caring and responsive domains were rated Good, with positive feedback on staff training, person-centred care and respect for cultural preferences.
Concerns (6)
criticalMedication management: “The provider did not always ensure care workers were provided with appropriate guidance to ensure medicines were administered as prescribed.”
criticalMedication management: “the visit in the morning occurred over one hour after the time indicated on the MAR chart. There was no guidance for care workers in relation to the importance of administering the time specific medicines as prescribed.”
criticalCare planning: “If the provider identified a specific risk which could be related to a person's health, wellbeing or care needs, a risk management plan had not been developed for care workers providing guidance”
criticalGovernance: “The provider did always have systems in place which were robust enough to enable them to identify where action was required. This was a breach of regulation 17(1)”
moderateRecord keeping: “We saw one person's care plan had not been updated to reflect a change to how their care was provided which had occurred in November 2021.”
moderateConsent / capacity: “the provider had not undertaken a mental capacity assessment to identify if the person had the capacity to make decisions about their own care.”
Strengths
· Robust recruitment processes including DBS checks, references and right to work checks
· Care workers received appropriate training, supervision and spot checks
· People and relatives reported care was kind, respectful and dignified
· Person-centred care plans identifying cultural, religious and communication preferences
· Registered manager demonstrated good understanding of duty of candour and safeguarding procedures
Quality-Statement breakdown (21)
safe: Using medicines safelyRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentGood
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 choicesGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies and supporting access to healthcareGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to meet needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Continuous learning and improving careRequires improvement
well-led: Managers and staff understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood