SNE Care Services Ltd improved from Requires Improvement to Good following a focused inspection of Safe and Well-led domains, having remediated a prior breach of Regulation 17 around governance and medicines management. All previously identified concerns were addressed, with no new breaches found.
Strengths
· Medicines now managed safely with daily audits and trained competent staff following previous breach
· Robust recruitment processes including reference checks and right-to-work verification now in place
· Risk assessments in place with regular reviews and lessons learned shared with staff
· Infection control measures effective with up-to-date PPE and IPC policy
· Quality monitoring and assurance systems improved with timely follow-up on actions
Quality-Statement breakdown (9)
safe: Using medicines safelyGood
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongGood
safe: Preventing and controlling infectionGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empowering, which achieves good outcomes for people; Continuous learning and improving careGood
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristics; Working in partnership with othersGood
well-led: How the provider understands and acts on the duty of candourGood
Focused inspection found the service rated Requires Improvement overall, with breaches of Regulation 17 (Good Governance) due to unsafe medicines management, weak recruitment reference checks and ineffective auditing systems. The registered manager acted immediately on feedback and had ongoing improvement plans, with safeguarding and infection control remaining effective.
Concerns (10)
criticalMedication management: “Medicines were not always given safely or as prescribed.”
criticalMedication management: “One person's medicines were not given at the prescribed times and staff had not understood that these medicines were time sensitive.”
criticalGovernance: “Medicine audits did not follow good practice guidance. Medicines records were sometimes amended up to a week after the care visit had taken place.”
moderateRecord keeping: “On occasion staff were asked to confirm if medicines were given several days after the medicines should have been administered”
moderateStaff competency: “References were not always checked enough to ensure they matched application forms, were valid or were from the most appropriate source.”
moderateMissed or late visits: “some calls were still happening outside of the agreed times and sometimes over an hour late.”
moderateStaffing levels: “I am getting new people some of the time, not all of the time. I get them and then I don't see them for weeks. There's quite a few different carers.”
moderateStaff training: “staff did not always have the right skills for the person, such as knowledge of dementia, and some commented that they had communication difficulties with some staff.”
moderateCare planning: “Some risk assessments, however, did not give clear or consistent details, for example about people's diets or in relation to medicines they were taking.”
moderateLeadership: “the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality care.”
Strengths
· People were safeguarded from abuse and staff had received safeguarding training
· Effective infection control procedures with plenty of PPE available
· Registered manager was committed to continuous learning and acted immediately on inspection feedback
· Care plans were person centred and focused on maintaining independence
· Service worked in partnership with external agencies and acted on feedback
Quality-Statement breakdown (11)
safe: Using medicines safelyRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Learning lessons when things go wrongNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Preventing and controlling infectionNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement