moderate“there was a reliance on informal rather than formal systems to assess and monitor the service. For example there was no system to review the daily records written by staff during visits”
moderate“the registered manager was not fully clear about what events they were required to notify us of. We had not received any notifications from the service.”
critical“The registered person had not always assessed, monitored and improved the quality and safety of the care and treatment provided.”
record keeping
2 findings
moderate“We found a number of records were not up to date, such as staff training records. Some activities had not been recorded, such as competency checks on staff for administering medicines.”
moderate
“Records were not always accurate, complete and contemporaneous in respect of each service user.”
staff competency
1 finding
minor“Some activities had not been recorded, such as competency checks on staff for administering medicines.”
staff training
1 finding
moderate“staff had not received refresher training in key areas of care for up to five years... safeguarding of adults, infection control and medicines.”
supervision appraisal
1 finding
moderate“Staff received a six-monthly spot check of their performance... Due to the gaps in staff training, we did not feel this frequency was sufficient.”
care planning
1 finding
moderate“where people required support with their medicines or mobility, risk assessments either lacked detail or were not in place.”
medication management
1 finding
minor“Some people required different levels of support... Care records were not sufficiently detailed to explain to staff what type of prompting or supervising people required.”