Mushkil Aasaan is a Good-rated domiciliary care agency serving 120 people, with strengths in safe staffing, culturally appropriate care, medicines management and open leadership. Only safe and well-led were inspected; effective, caring and responsive ratings were carried forward from the previous 2019 Good inspection.
Strengths
· People felt safe with care workers and timekeeping was consistently praised; same carers provided daily fostering continuity.
· Robust recruitment processes including DBS checks, reference checks and employment history verification.
· Medicines administered safely with care plans detailing prescriptions, staff trained, and records checked regularly by office staff.
· Culturally appropriate care provided, particularly for the South Asian community, with inclusive practice.
· Effective governance including electronic call monitoring, weekly log book audits, and regular care plan reviews.
Quality-Statement breakdown (11)
safe: Systems and processes to safeguard people from the risk of abuse
Good
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
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: Managers and staff being clear about their roles and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people, the public and staff; continuous learning and improving careGood
Mushkil Aasaan is a domiciliary care service rated Good overall following its May 2016 inspection, with strengths in safe recruitment, staff training, timekeeping, and complaints handling. A breach of Regulation 18 was found for failure to notify CQC of safeguarding-related incidents, and formal one-to-one staff supervisions were not being carried out in line with the provider's own policy.
Concerns (5)
criticalGovernance: “There were some incidents for which we did not receive a formal CQC notification. This is a breach of Regulation 18 of the Health and Social Care Act 2008.”
moderateSupervision / appraisal: “For two care worker's their last recorded one to one meeting with their supervisor was June 2014 and there were no records for these.”
minorGovernance: “The makeup of these records differed from the spot checks template contained in the spot checks policy and procedure.”
minorRecord keeping: “Care workers did not always write down which medicines they had prompted people to take.”
minorCare planning: “Not all of the care plans had been transferred to the new style.”
Strengths
· Robust staff recruitment checks including DBS, references, and right-to-work verification
· Staff received a thorough six-week induction programme based on the Care Certificate
· People felt safe with care workers and praised their moving and handling competency
· High level of on-time visit attendance with proactive communication when running late
· Complaints were documented, investigated in a timely manner, and acted upon
Quality-Statement breakdown (11)
safe: SafeguardingGood
safe: Staffing levels and timekeepingGood
safe: RecruitmentGood
effective: Training and inductionGood
effective: Supervision and appraisalRequires improvement
effective: Consent and Mental Capacity ActGood
caring: Dignity, respect and person-centred careGood
responsive: Care planning and needs assessmentGood
Mushkil Aasaan is a domiciliary care service rated Good across all five key questions at its January 2019 inspection, maintaining the rating awarded at its previous inspection in May 2016. The service excels in culturally sensitive, person-centred care for the south Asian community, with strong staff support systems, robust care planning, and effective governance.
Strengths
· Cultural matching process pairing care workers with service users by language, cultural and religious needs, fostering long-term trusting relationships
· Comprehensive care planning including risk assessments, mental capacity considerations, and regular reviews
· Strong staff training programme including Care Certificate induction, ongoing mandatory training, and QCF Level 3 support
· Regular supervision and appraisal system including in-the-field observations by care coordinators
· Effective complaints handling with proactive investigation and resolution to complainant satisfaction
This focused inspection confirmed that Mushkil Aasaan had remedied a previous breach relating to failure to submit statutory notifications to the CQC. Improvements were found to be sufficient, resulting in a Good rating for well-led.
Concerns (1)
moderateGovernance: “At our previous inspection we found that the provider did not always notify the CQC of notifiable incidents.”
Strengths
· Provider had submitted statutory notifications of notifiable incidents following previous breach
· Provider kept a log of incidents and complaints along with supporting documents and correspondence with relevant authorities
· Provider was aware of the type of incidents required to be notified to CQC and local authority
responsive: Complaints handling
Good
well-led: Notifications to CQCRequires improvement
well-led: Quality assurance and governanceRequires improvement