Medical Express (Domiciliary Care) was rated Good overall at its first inspection, with Good ratings in safe, effective, caring and responsive but Requires Improvement in well-led due to a lack of formalised quality assurance systems. Recommendations were made around the medicines policy and risk assessment practice.
Concerns (4)
moderate
Governance
: “The provider did not have effective quality assurance systems to monitor service delivery as they did not have a formalised system to monitor the service.”
moderateMedication management: “the provider was not following their medicines policy”
moderateRecord keeping: “they completed regular audits, carried out spot checks and had regular quality assurance calls but these were not recorded.”
minorCare planning: “the risk management plan for one assessment was not robust enough to clearly inform staff of the action they needed to take to minimise potential risks.”
Strengths
· Safe recruitment procedures including DBS pre-employment checks
· Effective safeguarding systems and up-to-date staff safeguarding training
· Staff had access to appropriate PPE and weekly COVID-19 testing
· Detailed pre-service assessments considering culture, religion and language
· Person-centred care with flexible call times and dedicated staff as preferred by the person
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementNot rated
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated
well-led: Working in partnership with others; Continuous learning and improving careNot rated