Domiciliary Care Dorset was rated Good overall following an announced inspection in March 2018, with all five key questions rated Good. Recommendations were made regarding the formal recording of mental capacity assessments, best interest decisions, audit documentation, and supporting people to express end-of-life wishes.
Concerns (7)
moderate
Consent / capacity
: “the best interest decision had not been formally recorded. The registered manager told us they would put this in place.”
moderateMedication management: “gaps in medicine records for two people and a medicine error for another person had not been identified through the medicine audit.”
moderateGovernance: “audits and checks carried out by the registered manager were not fully documented in relation to the management of the care provided.”
minorRecord keeping: “records of what care plans were checked and identified actions were not recorded by the registered manager.”
minorEnd-of-life care: “We recommend that the provider supports people to express their preferences and choices for the end of their life.”
minorIncident learning: “there were two incidents that the registered manager had not been made aware of but action had been taken to ensure the person's needs were met.”
minorCare planning: “for one person, their communication needs had not been fully assessed to identify if staff could use other communication methods, such as pictures.”
Strengths
· Staff had received safeguarding training and understood their responsibilities to report concerns, including whistleblowing procedures.
· Risk assessments were completed collaboratively with health and social care professionals and reviewed regularly.
· Safe recruitment practices were followed including DBS checks, references and right-to-work verification.
· Staff received training described as 'fantastic' and 'brilliant', with supervision, team meetings and competency checks in place.
· Care plans were person-centred, detailed and regularly reviewed, with input from healthcare professionals and relatives.
Quality-Statement breakdown (15)
safe: Safeguarding and risk managementGood
safe: Staffing levels and recruitmentGood
safe: Medicines managementGood
safe: Infection controlGood
effective: Staff training and supervisionGood
effective: Care needs assessment and planningGood
effective: Mental Capacity Act complianceGood
effective: Nutrition and healthcare accessGood
caring: Dignity, respect and person-centred approachGood
caring: Communication and accessible informationGood
responsive: Personalised care and activitiesGood
responsive: Complaints handlingGood
responsive: End of life care planningGood
well-led: Culture and leadershipGood
well-led: Governance and quality assurance auditsGood