This focused inspection of One Day At A Time Home Care Ltd found the Safe key question had improved to Good following resolution of previous medication management and governance breaches, while Well-led remained Requires Improvement as quality assurance improvements had not yet been fully embedded and sustained. The overall rating improved from Requires Improvement to Good.
Concerns (2)
moderateGovernance: “auditing of one person's care records did not identify improvements required.”
moderateGovernance: “time was required to show these improvements had been embedded and sustained.”
Strengths
· Medicines were given safely with individualised PRN guidance and documented MAR records; missed medicine alerts investigated same day.
· Risk assessments were clearly written and easy to follow, covering individual conditions, equipment use, and business continuity including COVID-19.
· Staff had sufficient travel time between visits and people were consistently supported by the same staff, enabling continuity of care.
· All staff had up-to-date safeguarding and infection control training; PPE use was confirmed by people and relatives.
· Incident and accident log evidenced lessons learnt shared via team meetings and supervisions.
This targeted inspection of One Day At A Time Home Care Ltd, prompted by a warning notice, found the service remained Requires Improvement overall, with Well-Led rated Inadequate, as incomplete staff employment histories constituted a continued breach of Regulation 19 despite improvements to risk assessments and governance processes. The provider had remedied breaches of Regulation 12 and Regulation 17 through better care planning, spot checks, management meetings and staff supervision, but full compliance with Regulation 19 had not been achieved by the required date.
Concerns (4)
criticalStaffing levels: “2 out of 4 staff files looked at did not show a full employment history. There were still gaps in staff's employment history that needed to be obtained.”
criticalGovernance: “Not enough timely action had been taken and the provider was still in breach of regulation 19 (Fit and proper persons employed)”
moderateRecord keeping: “on the 'action required' section of the document, in two care files, further written guidance for staff needed to detail what specific steps would need to be taken”
moderateSupervision / appraisal: “The registered manager told us they had now delegated out supervision to staff in the management team, where staff will receive supervision on a three monthly basis.”
Strengths
· Comprehensive and highly detailed risk assessments with step-by-step guidance introduced for all care files.
· DBS checks applied for all staff, protecting people from unsuitable workers.
· Environmental risk assessments introduced for people's homes with risk control measures.
· Body maps introduced to record accidents and incidents with referrals documented.
· Management meetings introduced with agendas and notes, covering CQC report, communication, recruitment and training.
Quality-Statement breakdown (3)
safe: Staffing and recruitment – fit and proper persons employed (Regulation 19)Requires improvement
safe: Assessing risk, safety monitoring and management (Regulation 12)Good
well-led: Managers and staff being clear about their roles, quality performance, risks and regulatory requirements (Regulation 17)Inadequate