critical“gaps in staff recruitment records including missing references, gaps in employment history, and a lack of evidence of Disclosure and Barring [DBS] checks”
moderate“Recruitment records did not always demonstrate best practice had been followed in the recruitment of staff.”
minor“Some further detail around people's abilities to assist with the administration of their own medicines, and less restriction around the structure of generic risk assessments, would assist staff further.”
governance
2 findings
critical“continued breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Regulation 17. Good governance.”
critical
“Records were not satisfactorily maintained in relation to recruitment, training, MCA and complaints. Systems to monitor the quality and safety of the service had not picked up all the shortfalls we identified.”
communication with families
2 findings
moderate“communication could be very poor between them and the manager or office based staff. Staff told us a minority of office staff could be rude”
minor“Some care workers told us that they did not always get the messages they thought they should from management and at times they struggled to contact team leaders.”
care planning
2 findings
minor“care workers had adapted the care they provided to suit a person's changing needs, but this was not reflected in care records or reported back to office staff.”
minor“Some care records were in need of further detail to make them more person-centred... environmental risk assessment carried out by the organisation was generic and would benefit from some personalisation.”
staffing levels
1 finding
moderate“Recruitment was ongoing at the time of the inspection as it was recognised there was a shortfall in numbers required to ensure staff were not working excessively long hours”
missed or late visits
1 finding
moderate“told us there had been initial difficulties with missed and late calls, but this had since settled down”
staff training
1 finding
critical“30 out of 61 care workers had requested training in how to care for people living with dementia, and 37 had requested training in supporting people with mental health issues.”
consent capacity
1 finding
critical“restrictions had been placed on them in their best interests and that covert medicine was in fact being administered...best interests' decisions had not been documented.”
complaints handling
1 finding
moderate“Complaints records and responses varied in quality and detail. There was no standard recording format and the outcome of complaints...was not always recorded.”
staff competency
1 finding
minor“Competency checks were not always documented but staff told us they had been assessed and that they had received appropriate training in this area.”
supervision appraisal
1 finding
minor“Supervisions and appraisals took place although in some team areas these were outstanding... not all appraisals had been completed for the previous year.”