critical“Staff supported a person to take their prescribed medicines covertly...this arrangement was not set out in their agreed support or risk management plans and there was also no clear record that this support was safe.”
record keeping
1 finding
moderate“The provider did not always ensure maintain accurate and up to date records regarding the management of the service.”
care planning
1 finding
moderate“Support and risk management plans set people's care and support needs but did not always reflect how staff met those needs or provide sufficient guidance for staff on how to do so.”
consent capacity
1 finding
critical“A relative had signed to give consent to care for a person who did not have the mental capacity to do so themselves. However, the provider did not have evidence that the relative had the legal authority to consent.”
governance
1 finding
critical“The provider's checks and audits to monitor the quality of the service and make improvements had not enabled the provider to identify and take timely action to address the issues we had found.”
staff competency
1 finding
critical“The provider had not always made reasonable efforts to complete appropriate recruitment checks for 3 staff before employing them.”
person centred care
1 finding
moderate“There was a lack of evidence that the service had used person-centred planning tools and approaches to plan and review people's support to ensure it was always personalised, holistic, and strengths-based.”
safeguarding
1 finding
moderate“Staff were required to record a balance of a person's collective monies...but staff only had access to the person's money held on site. This placed people at risk of financial harm.”