Home Instead South Manchester was rated Good overall at its first inspection in May 2017, with strong person-centred care, consistent staffing and compassionate practice praised by people and relatives. The Well-Led domain was rated Requires Improvement due to governance gaps including inadequate incident analysis, unresolved medication error follow-up, incomplete consent records and insufficiently detailed complaints recording.
Concerns (6)
moderate
Incident learning
: “No formal analysis of incidents had been done so we could not easily identify trends or patterns regarding these incidents.”
moderateMedication management: “For the fourth incident, we did not see what action, if any, the service had taken to help ensure such incidents were minimised.”
moderateGovernance: “Current audit systems did not effectively identify the issues we found at this inspection such as gaps in accident and incident reporting, incomplete incident forms.”
moderateConsent / capacity: “In two care records, we noted a relative had signed consent and we did not see any record of such [legal authorisation] in their files.”
moderateRecord keeping: “Some records did not document what follow up action, if any, had been taken... instances where a body map should have been completed and had not been.”
minorComplaints handling: “The minutes contained no details of the issue, the discussion and how the matter had been addressed... detailed records had not been kept.”
Strengths
· People and relatives consistently reported feeling safe and praised the consistency of regular care staff.
· Strong person-centred care planning with detailed, individualised care records reflecting people's histories, preferences and aspirations.
· Effective staff matching system using 'This is Me' profiles to pair caregivers with compatible clients, fostering strong relationships.
· Electronic call monitoring system in place to ensure visits were attended on time and missed calls identified promptly.
· Robust safeguarding awareness among staff, with appropriate training and clear understanding of reporting responsibilities.
Quality-Statement breakdown (20)
safe: Recruitment processesGood
safe: Safeguarding awarenessGood
safe: Medication managementRequires improvement
safe: Accident and incident recordingRequires improvement
Home Instead South Manchester received an overall Good rating across all five key questions at its January 2020 inspection, with 30 people receiving personal care. The single area of concern was incomplete pre-employment checks in staff recruitment, resulting in a recommendation, though no evidence of harm to people was found.
Concerns (3)
moderateStaff competency: “Safe recruitment procedures were not always followed. We found checks into staff members' histories had not been thorough enough. Some checks with previous employers in health and social care had not always been made.”
minorRecord keeping: “Although the registered manager routinely assessed people's capacity and held best interest discussions with key people, this was not always formally documented.”
minorConsent / capacity: “We noted one person may have required a review around the extent and level of supervision the service was providing to ensure compliance with legislation.”
Strengths
· People felt safe and staff demonstrated a good understanding of safeguarding responsibilities
· Medicines were managed safely with regular competency checks for administering staff
· Care plans were person-centred, up-to-date and regularly reviewed with input from health and social care professionals
· Staff were kind, respectful and knew people's individual needs, preferences and routines well
· Strong open management culture with effective quality assurance, monthly audits and continuous improvement focus
Quality-Statement breakdown (22)
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyGood
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 controlGood
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: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood