Like Care Limited was rated overall Good at its first inspection, with staff demonstrating strong person-centred care, safe medicines management and effective multi-agency working. However, a Requires Improvement rating for well-led reflected incomplete risk assessments and care plans, gaps in end-of-life care documentation, and failures to submit statutory notifications to CQC.
Concerns (4)
moderate
Record keeping
: “identified risks had not always been recorded thoroughly. This meant staff did not always have complete written information regarding people's risk management.”
moderateCare planning: “Care plans did not always contain complete and current information...care plans did not consistently document the approaches staff should follow.”
moderateEnd-of-life care: “one person required end of life care, however no information was documented about their final wishes or specialist professional involvement.”
moderateGovernance: “We found 2 instances where we were not notified of key events or changes. The provider acted to ensure notifications were submitted as required.”
Strengths
· Staff demonstrated strong knowledge of people's risks and escalation processes despite gaps in written records.
· Medicines were administered safely with staff trained and competency-assessed.
· Staff wore appropriate PPE and completed mandatory infection control training.
· People felt safe and were protected from abuse; staff understood safeguarding procedures.
· People and relatives were involved in care planning and reported high satisfaction with care.
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and managementNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control; End of life care and supportNot rated
responsive: Supporting people to develop and maintain relationships to avoid social isolationNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Working in partnership with othersNot rated