Friendly Homecare received a Good rating across all five key questions at its September 2023 inspection, demonstrating safe, person-centred care with strong leadership and staff consistency. Two recommendations were made regarding consistent application of the Mental Capacity Act for best-interest decision recording and updating care plans to include end-of-life wishes.
Concerns (2)
moderate
Consent / capacity
: “where people did not have the capacity to consent to their care, relatives without the legal authority to do so, had signed to give their consent to the care provided”
minorEnd-of-life care: “Care plans did not include people's end of life wishes.”
Strengths
· Low staff turnover providing consistency of care with people supported by the same staff
· Strong safeguarding systems and staff trained to recognise and report abuse
· Person-centred care plans with 'This is me' documents capturing social and background history
· Cultural and religious needs recorded and respected by staff
· Open and accessible management culture with registered manager maintaining direct contact with people and relatives
Friendly Homecare achieved a Good rating across all five key questions at this announced inspection on 7 November 2017, demonstrating sustained improvement following a Requires Improvement rating in January 2017. All previously identified regulatory breaches relating to safe care and treatment, consent, fit and proper persons employed, and good governance had been addressed.
Strengths
· Comprehensive risk assessments and management plans in place for all people using the service, reviewed six-monthly or sooner if required
· Medicines managed safely with MAR audits, competency testing, and elimination of secondary dispensing identified at previous inspection
· Safe recruitment procedures followed including DBS checks, two references, and risk assessment where convictions disclosed
· Staff received induction, regular supervision, unannounced field observations, and annual appraisals
· Mental Capacity Act compliance improved since previous inspection with individual capacity assessments documented
Friendly Homecare received an overall rating of Requires Improvement at its first CQC inspection in January 2017, with four regulatory breaches identified covering safe care and treatment, medicines management, consent, and governance. Strengths included caring and consistent staff, good safeguarding awareness, and an accessible registered manager, but significant gaps in risk management plans, MAR chart auditing, capacity assessments, and incident analysis required urgent remediation.
Concerns (7)
criticalMedication management: “MAR charts were not being audited by the service so there were no checks and balances in place to ensure care workers were administering medicines correctly and safely.”
criticalCare planning: “one file indicated the person self-harmed but there was no risk management plan for how to minimise the risks, what signs to be aware of or how to manage the behaviour.”
criticalConsent / capacity: “family members had signed on behalf of their relatives but there was no clear indication of why the person who used the service was unable to sign the care plan.”
criticalGovernance: “they did not always record outcomes or analyse service information such as incidents and accidents, nor did they have written audits for medicines or finance.”
moderateIncident learning: “Details of the incident were described but there was no record of the follow up or analysis of trends recorded to improve future service delivery.”
moderateRecord keeping: “care records and care workers' files lacked audits to ensure files contained evidence that systems were being followed.”
minorStaffing levels: “Some relatives commented that the service would benefit from more care workers and two care workers said sometimes they would like to have more time for calls or between calls.”
Strengths
· Care workers were kind, caring and had built positive relationships with people using the service.
· Staff received induction training, regular supervision, appraisals and spot checks every two months.
· People and their relatives were involved in care plans and six-monthly reviews.
· The registered manager was accessible and responsive; a 24/7 on-call system was in place.
· Safeguarding policies were up to date and care workers were trained to identify and report abuse.