Nationwide Care Services Ltd (Wolverhampton) was rated Requires Improvement overall at its first inspection in June 2023, with breaches of Regulation 17 identified due to governance systems failing to detect gaps in care planning, Mental Capacity Act compliance, and medication guidance. Caring and Responsive were rated Good, reflecting positive feedback from people and relatives about compassionate, person-centred care.
Concerns (7)
criticalGovernance: “Systems in place were not robust to ensure people were protected from harm. This was a breach of regulation 17 of the Health and Social Care Act 2008.”
moderateCare planning: “there were not always detailed, individual care plans in place. For example, when people had health conditions or periods of emotional distress.”
moderateCare planning: “Care plans and risk assessments were not always reviewed to reflect the changes made in response to incidents”
moderateMissed or late visits: “one person told us, 'I have to call out of hours. 1 or 2 hours late.' Another person told us, 'Once or twice not turned up.'”
moderateConsent / capacity: “People did not always have capacity assessments in place that were specific to the decision being made.”
moderateMedication management: “'As required' medicines did not always have clear guidance for staff to follow to support them to administer these medicines safely.”
moderateGovernance: “audits had not identified all the areas requiring improvement that we identified during our inspection.”
Strengths
· People felt safe and were happy with the care they received, with safeguarding procedures in place and followed.
· Medicines were administered as prescribed and staff competency in medicines administration was regularly checked.
· Infection control procedures were followed and staff had access to adequate PPE.
· Staff treated people with dignity, respect and compassion, knowing their preferences and needs well.
· People and relatives were involved in care planning and reviews.
Quality-Statement breakdown (24)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
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
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: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
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: Engaging and involving people using the service, the public and staffGood
well-led: How the provider understands and acts on the duty of candourGood