YoD Care Services (Oxfordshire) is a domiciliary care service that at the time of this assessment was supporting one person in their own home with a regulated activity of personal care. Not everyone using the service received personal care. CQC only inspects where people receive personal care, which is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. We carried out this between assessment 8 March 2024 to 17 April 2024. This was a responsive assessment as there had been concerns raised about the service and how it managed and responded to having a Home Office sponsorship licence. We looked at how YoD Care Services (Oxfordshire) assessed and planned people’s care, recruited and trained staff and encouraged staff to speak up, worked with other professionals and monitored the service. The provider's quality assurance systems were not always effective, this meant people could be at risk of harm. We identified that improvements could be made. For example, there was a lack of recording and investigation of some events, such as missed medicines and there was a lack of analysis of the quality assurance audits that were carried out. However, the relative of the person using the service and staff gave mainly positive feedback about the service. The service is rated Good and until we have assessed more quality statements in Effective, Caring and Responsive the rating for this service remains the same.
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YoD Care Services (Oxfordshire) improved from Requires Improvement to Good following a focused inspection of the Safe and Well-Led key questions. The service demonstrated effective safeguarding, medicines management, risk assessment, and governance systems, with the registered manager having successfully completed all actions from the previous inspection's action plan.
Strengths
· People and relatives reported feeling safe; safeguarding systems and staff training were effective
· Medicines managed appropriately with electronic monitoring, accurate records, and staff spot checks
· Sufficient staffing levels with electronic monitoring of support visits
· Risk assessments were in place, regularly reviewed, and guided staff practice effectively
· Governance improved since last inspection; action plan from April 2022 fully completed
YoD Care Services (Oxfordshire) was rated Requires Improvement overall at its first inspection, with a breach of Regulation 17 (Good Governance) due to ineffective quality monitoring systems, generic non-service-specific policies, and issues with punctuality, missed visits, and medication protocols. Caring, effective, and responsive domains were rated Good, reflecting person-centred care plans, trained staff, and a committed registered manager who responded promptly to concerns raised during the inspection.
Concerns (8)
criticalGovernance: “Systems to monitor quality were not always effective and did not identify our concerns relating to risks and medicine records.”
criticalRecord keeping: “Some records were not specific to the service. We looked at a range of policies and saw they were all generic and did not specifically relate to the service.”
moderateMissed or late visits: “"Their time keeping leaves a lot to be desired", "No-one tells us that they are running late." Some people had experienced a missed visit.”
moderateCare planning: “One person's care plan referenced the person was at risk of developing pressure ulcers... there was no specific assessment for this risk.”
moderateMedication management: “We could not find protocols to ensure the safe administration of 'as required' medicine (PRN). One person's medicine assessment was unclear.”
moderateCommunication with families: “"Whenever I have phoned the office, I have been put through to the owner who always seems to be driving. This leads to errors as they do not make notes."”
minorInfection control: “The policy was generic and not specific to YoD care services. The infection control policy had no schedule for staff testing for COVID 19.”
minorPerson-centred care: “Some notes were not detailed and related to tasks. This did not always provide a pen picture into people's mood or wellbeing.”
Strengths
· People felt safe and staff understood safeguarding responsibilities, with clear reporting processes in place.
· Staff received appropriate induction linked to the Care Certificate and ongoing role-specific training.
· Care plans were person-centred, regularly reviewed, and developed with involvement from people and their relatives.
· Sufficient staffing levels were consistently maintained, including where two staff were required.
· Staff demonstrated good understanding of Mental Capacity Act principles and sought consent appropriately.
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyRequires improvement
safe: Preventing and controlling infectionRequires improvement
safe: Learning lessons when things go wrongGood
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
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
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
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: Improving care quality in response to complaints or concernsGood
responsive: End-of-life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
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