Care24Seven improved from requires improvement to Good overall, with previous breaches of regulations 9, 12 and 17 resolved through better risk assessment, care planning and governance. Safe remained Requires improvement due to weaknesses in lessons-learned recording and limited detail in COVID-19 risk assessments.
Concerns (7)
moderateIncident learning: “Incidents and accidents were recorded appropriately, and appropriate action taken, but records did not always include an analysis or evidence of lessons learned.”
moderateCare planning: “Risk assessments included the risk level such as low, medium or high. However, they did not show how the risk was calculated and what the risk level was once measures were in place to reduce this.”
moderateInfection control: “People's records included a COVID-19 risk assessment. However, these lacked details and did not consider people's age, medical history, and any conditions which put them at higher risk should they contract the virus.”
minorStaffing levels: “The registered manager told us they had struggled with staff shortages during the pandemic, as some of the staff had left and it had been difficult to recruit new ones.”
minorStaff training: “The training matrix indicated some of the training was overdue.”
minorCommunication with families: “there was no explanation as to what the sounds or facial expressions meant and how to interpret these.”
minorComplaints handling: “I have complained, and they don't seem to get back to me. There is a lack of engagement and they don't appear to deal with issues.”
Strengths
· People told us they felt safe and benefited from continuity of the same care workers
· Medicines were administered safely and as prescribed with no gaps in MAR signatures
· Effective electronic monitoring system allowed real-time oversight of visits and medicines
· Robust recruitment checks including references, right-to-work and DBS checks
· Staff felt supported by management; received induction, training, supervision and spot-checks
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementNot rated
safe: Learning lessons when things go wrongNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot 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: 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
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: Meeting people's communication needsNot rated
responsive: Supporting people to develop and maintain relationships to avoid social isolationNot 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: Engaging and involving people using the service, the public and staffNot rated
well-led: Continuous learning and improving careNot rated
well-led: Working in partnership with othersNot rated