ReadyCQC, a weekly field guide to CQC home-care regulation

Inspection report · 2023-06-08

Framework: KLOE · 17 pages · 99 KB · PDF

Requires improvement

safe: Requires improvementeffective: Requires improvementcaring: Requires improvementresponsive: Requires improvementwell-led: Requires improvement

MoreLoved Care Ltd received an overall rating of Requires Improvement at its first inspection, with three regulatory breaches identified covering safe care and treatment (Reg 12), person-centred care (Reg 9), and governance (Reg 17), the last resulting in a Warning Notice. While staff were regarded as kind and caring by people and relatives, systemic failures in care planning, risk assessment, record keeping, and governance processes presented increased risk of harm to the 11 people receiving personal care.

Concerns (11)

criticalCare planning: “People's care records and risk assessments were not comprehensive, did not always reflect people's care needs and were not always person-centred.”
criticalGovernance: “The provider did not have effective governance systems in place to assess, monitor and improve the quality and safety of people's care. This placed people at risk of harm.”
criticalRecord keeping: “On this matrix it stated that nearly all of the 17 staff had completed all their training courses on the same day. This was not possible as staff had different start dates.”
criticalConsent / capacity: “We asked the registered manager for copies of the person's care records and paperwork relating to this decision as they were not available during the inspection.”
criticalPerson-centred care: “Care plans followed a standardised format with little evidence of person-centred care planning.”
moderateMedication management: “The records used to record and monitor people's medicine management were not always completed appropriately.”
moderateEnd-of-life care: “The registered manager told us the person did not wish to discuss an end-of-life care plan and therefore there was not one in place. However, there was no record of this conversation.”
moderateCommunication with families: “The registered manager was unaware of the Accessible Information Standard.”
moderateCultural competency: “There was limited information within people's care records about their protected characteristics. The registered manager had limited understanding of the Equality Act 2010.”
moderateIncident learning: “Incidents records did not always include details of investigations completed and action taken to prevent reoccurrence.”
moderateStaffing levels: “During and following the inspection the provider had their overseas staff sponsorship license suspended and then removed... agency staff were used whilst permanent staff were recruited.”

Strengths

· People felt safe when staff were in their home and staff were described as kind and caring.
· Staff followed infection prevention and control practices effectively, including use of PPE.
· The registered manager was approachable, well-liked, and acted on concerns raised by people and relatives.
· Safeguarding training was in place and concerns were reported and investigated appropriately.
· Complaints systems were in place and relatives reported concerns were resolved promptly.

Quality-Statement breakdown (24)

safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices, delivering care in line with standards, guidance, and the lawRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidance

Inspection reports (2)