First inspection of a newly registered domiciliary care agency rated Requires Improvement overall, with significant historical issues around medicines management, safeguarding follow-up, recruitment and missed visits. A new manager had identified the concerns and was actively implementing a service improvement plan, with effective, caring and responsive domains rated Good.
Concerns (10)
critical
Medication management
: “The manager explained they had identified medicines had not been safely managed.”
criticalSafeguarding: “safeguarding's raised with the previous manager had not been investigated”
moderateStaff competency: “Staff had not always been recruited safely.”
moderateMissed or late visits: “We were told there had been some missed visits which the manager was aware of due to a staff member not following the correct procedure.”
moderateCare planning: “the manager had identified people's care plans did not contain enough detail to guide staff to meet their needs.”
moderateStaff training: “recruitment checks had not always been completed and staff training not completed.”
moderateGovernance: “It was evident from speaking with the provider and manager and looking at the SIP the service had not been operating safely.”
moderateLeadership: “Since the service registered there had been a couple of managers... At the time of the inspection there was not a manager registered with CQC.”
minorCommunication with families: “People were not informed about who and when staff would visit.”
minorIncident learning: “The manager had put in place a new system to record any incidents and accidents that occurred”
Strengths
· Staff treated people with kindness and respect; positive feedback from people using the service
· Effective infection prevention and control with sufficient PPE available
· Staff understood MCA principles and consent was checked at every visit
· Care plans encouraged independence and respected dignity
· Manager had developed a service improvement plan (SIP) and was actively addressing concerns
Quality-Statement breakdown (21)
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choicesNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enoughNot rated
effective: Staff working with other agencies; supporting access to 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 decisionsNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure choice and controlNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Duty of candourNot rated
well-led: Engaging and involving people, the public and staff; working in partnershipNot rated