critical“Medicines were not always administered safely. The registered manager told us they only 'Prompted people to take medication'. There was no information within the provider's medicine policy”
care planning
1 finding
critical“Care plans did not always contain up to date information on people's personal circumstances...Care plans did not have photos, or details of people's individual preferences.”
consent capacity
1 finding
critical“The provider had not always completed capacity assessments for people whose capacity to consent was in doubt. This was a breach of Regulation 11”
governance
1 finding
critical“Quality assurance systems such as audits were not being operated effectively...the provider's monitoring systems had failed to identify the concerns we found in relation to assessing risk and medicines management.”
person centred care
1 finding
critical“The lack of person-centred care plans placed people at an increased risk of not having their needs met. This was a breach of regulation 9 of the Health and Social Care Act 2008”
record keeping
1 finding
moderate“Accurate, complete and contemporaneous care records were not always maintained. Care plans and risk assessments were not audited to check that they contained all correct information.”
missed or late visits
1 finding
moderate“Over 41% of calls were less than half the planned time and some people were receiving their care calls later than agreed.”
supervision appraisal
1 finding
moderate“Staff supervision was however ad hoc and staff meetings did not happen regularly, one staff member said, 'I can't remember the last time that we had a staff meeting'”
infection control
1 finding
moderate“The NI was unable to provide us with any infection control audits that were carried out during the COVID-19 pandemic for staff or people using the service.”
leadership
1 finding
critical“The provider was not operating in line with their registration...the NI informed us they were not at the registered location as they had moved offices. They had not informed CQC.”