Lean On Me Care Services Limited received an overall Good rating on its first inspection, with staff praised for compassionate, person-centred care and safe recruitment practices. A regulatory breach was identified in medicines management due to incomplete and inconsistent MARS chart recording, and governance systems required strengthening to reliably detect care record gaps.
Concerns (3)
critical
Medication management
: “people's medicine administration record (MARS) charts had not always been effectively completed using standardised and agreed coding”
moderateGovernance: “their current audits had not always identified gaps in the management of people's medicines”
minorRecord keeping: “Discrepancies of staff employment histories were clarified at interview; however, these discussions were not consistently recorded”
Strengths
· People and relatives described staff as kind, caring, punctual and reliable, with comments such as 'They are a breath of fresh air'
· Safe recruitment practices including DBS checks and employment history verification were in place
· Staff received regular supervisions, induction, shadowing shifts and medicines competency reviews
· Health care professionals praised the service's responsiveness and proactive communication about changes in people's needs
· Person-centred care plans documented individual routines, preferences, cultural and religious needs, and personal goals
Quality-Statement breakdown (23)
safe: Using medicines safelyRequires improvement
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
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
effective: Ensuring consent to care and treatment in line with law and guidanceGood
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: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
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: How the provider understands and acts on the duty of candour; Continuous learning and improving careGood
well-led: Engaging and involving people using the service, the public and staffGood