critical“care plans lacked sufficient detail to ensure staff understood how to care for people safely... care plan and risk assessment did not contain any information to ensure staff understood how to carry out this task safely.”
medication management
1 finding
critical“Medicines were not managed safely in line with current best practice guidance. Care plans lacked sufficient detail to ensure staff understood the support people required to take their medicines.”
staff competency
1 finding
moderate“Staff received training in the administration of medicines, however, their competency had not been assessed in line with best practice guidance.”
staffing levels
1 finding
critical“The provider did not follow safe recruitment processes as they had not obtained a full employment history when recruiting new staff.”
infection control
1 finding
moderate“The infection control policy had not been updated with information and guidelines related to COVID-19. The provider had also not assessed the risk to people receiving care or staff.”
governance
1 finding
critical“The provider did not have effective systems in place to monitor the safety and quality of the service as they had not identified the issues we found with care plans, risk assessments, consent to care, medicine records.”
supervision appraisal
1 finding
moderate“some staff had not received a spot check or supervision in over 12 months.”
missed or late visits
1 finding
moderate“The systems in place to ensure people received their care visits as planned was not robust and the risk of failed visits had not been adequately assessed and/or mitigated.”