This assessment took place between 27 August and 18 September 2024. Blossom Care For You LTD is a domiciliary care agency providing personal care services to older adults in their own homes. During this assessment we looked at of 4 quality statement in the key question of safe and 3 quality statements in the key question of well led. The overall rating for this service combines scoring from the quality statements we looked at during this assessment and scores in line with findings from our last inspection, where the service was rated good. There was not an effective governance system to monitor and improve the quality of care and safety of the service. Auditing and quality assurance information was not always completed or available for inspectors to review. Completed audits were not always effective in identifying issues which needed to be addressed. The provider did always robustly assess and reduce risks related to people’s medicines management. Systems to ensure safeguarding incidents were robustly reported, investigated and analysed were limited. Incidents were not always fully investigated to reduce the risk of recurrence, and we found examples where the provider did not report safeguarding concerns to relevant professionals in a timely manner. There were enough staff in place to meet people’s needs. The provider had made improvements to the consistency of care since they reduced the number of people they supported. The provider had identified shortfalls in their staff recruitment processes. Work was ongoing to ensure all staff had the appropriate recruitment documentation and checks in place. We received positive feedback from staff and people about the changes made since the new management team was in place. The leadership team was open and pro-active in acting in response to feedback from inspectors when shortfalls were identified at this assessment.
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Blossom Care For You LTD improved from requires improvement to good overall, meeting previously breached regulations on safe care, medicines, consent and governance. However, well-led remained requires improvement due to the 12-month absence of a registered manager, incomplete management quality audits, and an inadequate business continuity plan.
Concerns (4)
moderateGovernance — “A comparable system of audits to monitor the quality of service management was not fully implemented and in use.”
moderateGovernance — “The absence of embedded systems and processes to monitor and improve the quality of the service meant there was a risk things would be missed.”
moderateLeadership — “There had been no registered manager in post for 12 months.”
moderateOther — “The provider did not have a suitable business continuity plan to use in the event of bad weather, outbreak of infectious disease or other emergency.”
Strengths
· Detailed risk assessments informed people's care plans, using evidence-based tools for malnutrition and pressure injuries.
· Medicines were administered safely with accurate records and monthly audits.
· Staff had appropriate training, induction and shadowing before working independently.
· Safeguarding systems and processes were in place and staff knew how to escalate concerns.
· Sufficient staffing levels with rare missed calls and good communication about lateness.
Quality-Statement breakdown (15)
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safely; Learning lessons when things go wrongGood
safe: Systems and processes to safeguard people from the risk from abuseGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Continuous learning and improving care: Working in partnership with othersRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement
well-led: Duty of candourRequires improvement
well-led: Engaging and involving people using the service, the public and staffRequires improvement