The assessment of Home-Care Perfection – Main Office was carried out from 4 August 2025 until 27 August 2025. The service provides domiciliary care to adults and children, including those living with dementia and physical disabilities. At the time of inspection, the service was supporting people across a range of age groups and needs. Since the previous inspection, where the service was rated Requires Improvement, significant progress has been made across all five key questions, resulting in a new rating of Good. People told us they felt safe and well cared for. Staff were found to be compassionate, respectful and responsive to people’s individual needs. Risk assessments were person-centred and regularly reviewed. Safeguarding procedures were robust and well understood by staff. Care was delivered in line with best practice, and staff worked effectively with health and social care partners to ensure continuity and positive outcomes. People’s care plans were up to date and accessible, and consent was consistently sought and documented. The service was well-led, with leaders fostering a culture of openness, learning and continuous improvement. Staff felt supported and valued, and there was a clear governance structure in place to monitor quality and safety. Feedback from people and relatives was actively sought and acted upon. The environment in which care was delivered was safe and well managed, and infection prevention and control measures were consistently applied. Overall, Home-Care Perfection demonstrated a strong commitment to person-centred care, safety, and continuous improvement. The leadership team promoted a positive culture that empowered staff and ensured people received high-quality, responsive support.
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Home-Care Perfection received an overall rating of Requires Improvement at its first inspection, with regulatory breaches identified in medicine management, risk assessment, Mental Capacity Act compliance, and governance. Strengths included caring, compassionate staff, robust recruitment and induction processes, and positive feedback from people and relatives about person-centred care.
Concerns (10)
criticalMedication management: “1 person was prescribed medication to be taken before food. We saw staff were providing this medication after food which meant there was a risk the medicine would not be effective.”
criticalMedication management: “Staff had not received any medication competency checks or assessments.”
criticalCare planning: “one person was at risk of falls from their chair, but there was no risk assessment in place to identify this risk or provide an action plan for staff to follow.”
criticalCare planning: “one person had returned from hospital with significant changes to their pressure area care. There was no short-term care plan in place.”
criticalConsent / capacity: “a decision had been made for limitations to be placed on food and drink accessibility within their home. There was no best interest decision or consent documented in their care file.”
criticalGovernance: “Governance systems were not effective and in some instances were not in place. This resulted in a lack of oversight for medication, risk assessments, call monitoring, complaints, accidents and incidents.”
moderateConsent / capacity: “Some staff had not completed their MCA training and other staff who had could not describe their understanding of the principles of the MCA.”
moderateIncident learning: “There was no evidence of lessons learnt as the providers system for recording near misses and low-level accidents was ineffective.”
moderateComplaints handling: “Complaints and concerns that had been raised were not robustly documented or monitored for patterns or trends to improve the service.”
minorRecord keeping: “care records did not show clearly where other professionals had been contacted to ensure people's health needs were met. District nurses and GP contact was not captured in the documentation.”
Strengths
· Safe recruitment processes were followed and checks were completed to ensure only suitable staff were employed.
· Staff received a thorough induction and shadowing processes with guidance and support from the first day of employment.
· Staff used personal protective equipment (PPE) and had regular compliance spot checks; adequate PPE supplies maintained.
· People received a detailed pre-assessment before the service agreed to proceed with the care package.
· Care plans were person-centred and detailed with people's histories, likes, dislikes and preferred routines.
Quality-Statement breakdown (18)
safe: Using medicines safelyRequires improvement
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Staff working with other agencies to provide consistent, effective, timely care; Supporting people to live healthier livesRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
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 care; Respecting and promoting people's privacy, dignity and independenceGood
responsive: Improving care quality in response to complaints or concernsRequires improvement
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferences; End of life care and supportGood
responsive: Meeting people's communication needsGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empowering; Working in partnership with othersGood
well-led: How the provider understands and acts on the duty of candour; Engaging and involving people using the serviceGood