Jaika Healthcare improved from Inadequate to Requires Improvement following a focused inspection on Safe and Well-led key questions, exiting Special Measures after addressing previous breaches around safe care, staffing, recruitment, and governance. Remaining concerns centre on inconsistent recording of information from other agencies and unclear notification responsibilities when safeguarding alerts are raised.
Concerns (4)
moderateGovernance: “further improvement was required to ensure systems were in place to consistently record all safeguarding's and quality information raised by other agencies.”
moderateSafeguarding: “The provider was unclear about their responsibility in notifying required agencies when safeguarding alerts were made or received.”
moderate
Record keeping
: “further improvement was required to ensure a system was in place to make sure information was shared with all other appropriate agencies as required.”
minorIncident learning: “There were no records of any accidents or incidents, therefore we were not able to check records to see what action had been taken in response.”
Strengths
· Clear care plans and risk assessments in place detailing support required for each person
· Guidance in place for 'as and when required' medications ensuring timely administration
· Staff demonstrated understanding of safeguarding and how to protect people from abuse
· Recruitment practices improved with references, employment gap checks, and DBS risk assessments in place
· Staff using PPE effectively and confirmed to have received infection control training
Jaika Healthcare, a small domiciliary care agency supporting 12 people, was rated Inadequate overall at its first inspection, with four regulatory breaches identified covering safe care and treatment, fit and proper persons employed, staffing, and good governance. Critical failures included absent medication guidance and audits, incomplete care plans and risk assessments, unsafe recruitment practices, and inconsistent staff training, placing people at risk of avoidable harm.
Concerns (14)
criticalMedication management: “no guidance for people's PRN 'as and when required' medications...no patch charts for medication patches and no record for the count and disposal of controlled drugs.”
criticalCare planning: “No risk assessments or care plans had been completed for three people with specific healthcare needs, which meant staff had no written guidance on how to safely meet their needs.”
criticalGovernance: “There was not a robust auditing system in place. This meant the service had not been operating effectively and had failed to identify the concerns we found during the inspection.”
criticalStaff training: “two staff had not completed the provider's induction training including training in topics such as infection prevention and control, fire safety awareness and equality and diversity training.”
criticalStaff competency: “staff had not completed moving and handling training with the provider and there was no record the provider had completed competency checks.”
criticalRecord keeping: “The provider had failed to identify that accurate records relating to people's care were not being maintained, to ensure staff had access to consistent and accurate information.”
moderateSafeguarding: “Staff training records showed one member of staff had not received safeguarding training therefore we could not be assured they would be able to identify and report concerns.”
moderateIncident learning: “There were no records of any accidents or incidents, therefore we were not able to check records to see what action had been taken in response or how the provider was using the information.”
moderateMissed or late visits: “travel time between calls had not been scheduled and there was no effective system in place to monitor the length of calls times...some calls were significantly shorter than the agreed and commissioned length of time.”
moderateCommunication with families: “Two relatives said that there had been a number of different staff to provide care and this was not always communicated. One relative commented, 'We didn't know who [was coming] until they arrived.'”
moderatePerson-centred care: “Care plans were not in place for known health conditions, this meant people had not been able to contribute to and agree the care plans for some aspects of their care.”
moderateInfection control: “We checked training records for three staff and found two staff had not completed training in infection control.”
moderateConsent / capacity: “two out the three care staff had not completed training in people's rights under the MCA and when to act in their best interests.”
minorSupervision / appraisal: “As it was still a new service care staff had not received supervisions at the time of the inspection.”
Strengths
· People and relatives said they felt safe and were happy with the care provided.
· Two healthcare professionals commented that communication with the provider was good.
· Staff demonstrated knowledge of people's individual needs and wishes.
· The provider was open and receptive to areas of concern and submitted a service improvement plan after inspection.
· Staff reported feeling supported and able to speak with the provider for advice.
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementInadequate
safe: Using medicines safelyInadequate
safe: Staffing and recruitmentInadequate
safe: Preventing and controlling infectionRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Learning lessons when things go wrongInadequate
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standardsGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietRequires improvement
caring: Respecting and promoting people's privacy, dignity and independenceRequires improvement
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 diversityRequires improvement
responsive: Planning personalised care to ensure people have choice and controlRequires improvement
responsive: Improving care quality in response to complaints or concernsRequires improvement
responsive: Meeting people's communication needsRequires improvement
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 requirementsInadequate
well-led: Engaging and involving people using the service, the public and staffRequires improvement
well-led: Continuous learning and improving careInadequate
well-led: How the provider understands and acts on the duty of candourRequires improvement