Date of assessment: 29 January to 19 February 2026. Medistaff24 is a domiciliary care agency registered to provide personal care to people in their homes. The service supports older people, younger adults, people with a learning disability and those living with a sensory impairment, physical disability or dementia. At the time of our assessment 12 people were receiving a regulated activity. We assessed the service against ‘Right support, right care, right culture’. This guidance supported judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choice, independence and access to local communities that most people take for granted. This announced inspection was carried out to review the quality of care and the service’s compliance with legal requirements. Right Care People’s care plans contained detailed and personalised information. Care was person-centred, and people were involved in decisions about their support. The service helped people maintain their health and wellbeing and promoted independence. People told us staff listened to them and responded quickly when they raised questions or concerns. Right Culture The service placed emphasis on staff engagement, wellbeing and enablement, supporting staff to deliver compassionate, person-centred care. Leaders promoted an open, inclusive culture, and staff told us they felt valued and able to approach management with any concerns. Right support Care was consistently provided in a way that was safe and met people's needs. Some aspects of people's care records needed to be improved. Mental capacity assessments were not always detailed and instructions to staff on administering certain PRN (as required) medicines were also not always clear. There was no evidence of this impacting on the care people received but more robust records would strengthen the information to support staff decision making and safe and effective medicines management. Governance systems were in place; however, we were not assured they were always effective in identifying shortfalls in quality, performance and risk.
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Medistaff24 was rated Requires Improvement overall at its first inspection in October 2022, with a regulatory breach under Regulation 19 due to significant gaps in staff recruitment records including missing written references, incomplete employment histories, and DBS checks not dated close to start dates. The service performed well in effective, caring, and responsive domains, with people reporting positive experiences and staff demonstrating good knowledge of individual needs.
Concerns (5)
criticalStaffing levels: “None of the staff employment records contained written references from the referee. The registered manager had recorded in the staff's file 'satisfactory phone reference' but there was no detail of any questions asked.”
criticalRecord keeping: “Staff employment records had gaps in information such as employment histories. There was no evidence that these gaps had been explored by the registered manager.”
criticalGovernance: “Effective and robust checks of staff employment records had failed to identify the issues we found. Improvement was needed to the provider's recruitment policy.”
moderateIncident learning: “There was no overall accident and incident analysis system in place. We discussed this with the registered manager, who assured us a system would be implemented.”
minorMissed or late visits: “There has been one missed care call. The registered manager told us this was due to a communication error.”
Strengths
· People and relatives felt safe with staff and provided consistently positive feedback about kindness and care.
· Risk assessments and risk management plans were in place and staff knew people well.
· Medicines were managed safely with MAR charts, protocols for 'when required' medicines, and body maps for topical preparations.
· Staff completed induction including shadowing shifts and ongoing online training.
· Care was personalised with consistent staff who knew people's preferences, including gender preferences.
Quality-Statement breakdown (25)
safe: Staffing and recruitmentRequires improvement
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongRequires improvement
effective: Staff support: induction, training, skills and experienceGood
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
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
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
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Managers being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: How the provider understands and acts on the duty of candourGood
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: Continuous learning and improving care; Working in partnership with othersGood