SylvianCare Swindon received an overall rating of Requires Improvement at its first inspection, with breaches of Regulation 12 (no risk assessments) and Regulation 17 (ineffective governance systems) identified. While staff were caring and medicines management was adequate, significant concerns included missed and late visits, staff deployed before DBS checks were completed, and people not being involved in their own care plans.
Concerns (7)
criticalCare planning: “There were no risk assessments in place to help keep people safe. Some risks had been identified but no assessment of the risks had been fully conducted.”
criticalStaffing levels: “staff had been deployed to care for people on support visits before the relevant DBS checks had been completed.”
criticalGovernance: “Failing to have systems in place to assess, monitor and improve the quality and safety of the service... was a breach of Regulation 17.”
moderateMissed or late visits: “Most people and their relatives told us staff were not punctual... People and their relatives told us they experienced missed visits.”
moderatePerson-centred care: “Nearly all the people we spoke with told us their opinions had not been sought. They also told us they had not seen their care plan.”
moderateLeadership: “"I don't have a lot of faith in them [service]" and "I have no confidence in the company at all."”
moderateRecord keeping: “None of the audits or monitoring identified our concerns in the Safe and Caring domains. An action plan had been created... no actions had been completed.”
Strengths
· Staff demonstrated good knowledge of people's conditions and support needs despite inadequate risk assessments.
· People's care plans were person-centred and focused on what was important to people.
· Staff received safeguarding training and understood responsibilities to report concerns.
· Medicine records were accurate, consistently maintained and up to date; staff competency in medicines administration was checked.
· Infection prevention and control measures were in place and PPE was used effectively.
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
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: Supporting people to express their views and be involved in making decisions about their careRequires improvement
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
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 empoweringRequires improvement
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 staff, fully considering their equality characteristicsRequires improvement
well-led: Continuous learning and improving care; Working in partnership with othersGood