C & S Care Services Limited was rated Good across all five key questions at its May 2015 inspection, having successfully remediated a previous medicines management breach identified in October 2013. The service demonstrated consistent strengths in safeguarding, person-centred care, staff training, and governance.
Concerns (1)
moderate
Medication management
: “At the last inspection in October 2013 the service was not meeting the requirements of the regulation of the safe management of medicines.”
Strengths
· Medicines management improved since previous inspection with clear audit trails and new recording systems implemented
· Staff had strong understanding of safeguarding processes and how to report concerns
· Clear risk assessments in care files with detailed guidance for staff
· Sufficient staffing levels with people receiving regular, consistent carers
· Staff well trained with regular refresher training, supervision and support
C & S Care Services Limited was rated overall Good at its March 2020 inspection, with four key questions rated Good and Well-Led declining to Requires Improvement due to ineffective governance audits and a failure to identify missing medicines guidance and unreviewed care records. People and relatives spoke highly of staff compassion and competence, and no breaches of regulation were identified.
Concerns (3)
moderateGovernance: “formal audits were not always completed, we could not be assured this was always effective in identifying areas for improvements.”
moderateMedication management: “it had not been identified that 'as required' guidance for people's medicines was not always in place.”
moderateRecord keeping: “for one person, no records had been returned to the office since they had started using the service in October 2019. Therefore, there had been no oversight or review of this documentation.”
Strengths
· People felt safe with staff and individual risks were regularly reviewed with clear guidance in place.
· Staff had up-to-date safeguarding training and understood how to recognise and report potential abuse.
· Medicines were managed safely with competency checks before independent administration.
· Staff received thorough induction including training and shadowing before working independently.
· People and relatives spoke positively about staff compassion, kindness, patience and dignity.
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and managementGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
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
C & S Care Services Limited was rated Good across all five key questions at its announced inspection in June 2017, maintaining its previous Good rating. People, relatives and staff consistently praised the service's leadership, staffing consistency, caring approach and effective quality assurance processes.
Strengths
· People felt safe and staff understood how to manage individual risks, including falls prevention and choking risks
· No missed calls reported; one person stated 'They haven't missed a call in two and a half years'
· Staff were well trained with hands-on medication training and regular spot checks by senior staff
· People received care from regular, consistent carers who knew their needs and preferences well
· Medicines administration was monitored with a system to identify and address omissions