UK Caring Services was rated Requires Improvement overall, with breaches of Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance) due to incomplete risk assessments, inadequate care plan detail, weak auditing and failure to notify CQC of safeguarding allegations. Caring remained Good with kind, respectful staff, but MCA practice, personalised care planning and managerial oversight required improvement.
Concerns (10)
criticalCare planning: “More than half of the risk management plans we reviewed lacked information to help staff provide safe care.”
criticalGovernance: “Auditing systems were not always operated effectively. Completed checks had not identified some care records and risk management plans lacked information.”
criticalRecord keeping: “Accurate and complete records in respect of each person were not maintained.”
criticalSafeguarding: “We had not been notified about two allegations of abuse that had occurred during March and July 2022.”
moderateCare planning: “The majority of people's care plans we looked at did not contain enough information.”
moderateConsent / capacity: “Decision specific mental capacity assessments had not always been fully completed during care planning to determine whether or not people had capacity”
moderateIncident learning: “incidents were not always analysed to identify triggers or patterns to prevent recurrence.”
moderateCommunication with families: “three out of five people spoken with explained they had difficulty communicating with staff who supported them for whom English was a second language.”
moderateLeadership: “Managerial oversight of the service needed to be strengthened and improved.”
minorMedication management: “a fifth person explained staff had forgot to apply their prescribed cream to their skin that morning.”
Strengths
· Staff were kind and caring, treating people with dignity and respect
· Safe recruitment practices including DBS checks and references
· Staff completed safeguarding and infection control training and followed safe PPE practice
· Good induction including Care Certificate followed by ongoing training and supervision
· 98% satisfaction in 2021 annual survey and 25 compliments received Feb-July 2022
Quality-Statement breakdown (21)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standardsGood
effective: Staff support: induction, training, skills and experienceGood
effective: Staff working with other agencies; supporting people to access healthcareGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisionsGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to meet needs and preferencesRequires improvement
responsive: Improving care quality in response to complaints or concernsGood
responsive: Meeting people's communication needsGood
responsive: End of life care and supportNot rated
well-led: Managers and staff understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Continuous learning and improving care; duty of candour; partnership workingRequires improvement
well-led: Engaging people and staff; promoting a positive person-centred cultureGood