Floating Support City was rated Good across all five key questions at its December 2016 inspection, with 13 people receiving personal care at the time. Minor recording gaps were identified in one mobility risk assessment and in care plan review sections, both of which management agreed to address promptly.
Concerns (3)
minor
Care planning
: “in one person's care plan the risk assessment regarding their mobility needed to be updated”
minorRecord keeping: “in the care plans we saw it was noted that more detail was needed in the review section to show what changes had taken place”
minorGovernance: “the registered manager told us that the response to surveys had been poor”
Strengths
· Staff demonstrated good knowledge of safeguarding procedures and reported no hesitation in raising concerns
· Effective recruitment procedures including DBS checks, references, and shadow shifts for new staff
· Staff received regular training covering safeguarding, MCA, infection control, dementia, medicines administration and more
· Staff received regular supervision and annual appraisals
· People's privacy, dignity and independence were respected and care was delivered in a person-centred way
Floating Support City achieved an overall Good rating at its October 2019 inspection, with staff praised for safe, person-centred and dignified care and strong medicines management and recruitment practices. The Responsive domain was rated Requires Improvement due to absent routine care plan reviews and inadequate end of life care planning and documentation.
Concerns (6)
moderateEnd-of-life care: “The provider had only recorded some end of life information in relation to one of these people within their generic support plan. There was not a comprehensive record such as an 'advanced care plan'”
moderateCare planning: “The provider reviewed care plans whenever a change was identified but did not have a schedule of routine reviews.”
minorRecord keeping: “For people at risk of weight loss or malnutrition, there were not always separate dedicated records of how much they were eating and drinking.”
minorRecord keeping: “a person at risk of pressure ulcers did not have a dedicated recording tool to systematically monitor their skin.”
minorConsent / capacity: “The provider had not always recorded when a person had appointed a Lasting Power of Attorney to make decisions on their behalf.”
minorPerson-centred care: “the provider had recently decided to only offer minimum calls of 3 hours duration for all new care visit requests...this was found to be restrictive by some of the current people receiving care”
Strengths
· People felt safe and protected from abuse; staff demonstrated strong awareness of safeguarding procedures.
· Robust recruitment process and stable staffing following service restructure, with electronic call monitoring ensuring no missed visits.
· Medicines management was well organised with monthly audits, staff training and regular competency checks.
· Staff described as kind, caring and respectful, actively promoting dignity, independence and community engagement.
· Person-centred care plans recorded individual history, preferences and objectives; consent consistently sought.
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
safe: Assessing risk, safety monitoring and managementGood
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: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
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: End of life care and supportRequires improvement
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesRequires improvement
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
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 candour; Continuous learning and improving careGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood