Focused inspection of safe and well-led key questions following safeguarding concerns found the service remained Good overall, with safe medicines management, sufficient staffing and confident leadership. Minor recommendations were made regarding the covert medication policy, and staff supervision had fallen behind due to pandemic pressures but was being addressed.
Concerns (6)
moderateSupervision / appraisal — “Individual staff supervision meetings and support visits, where senior staff observed care staff at work, had fallen behind due to staff sickness and staff leaving.”
moderateStaffing levels — “The service had recently lost some staff who worked in the Bournemouth area... this had meant some people had experienced changes in staff.”
minor
Medication management
— “The provider's medication policy did not address covert medication. We signposted the registered manager to CQC's information about covert administration of medicines for adult social care services.”
minorCommunication with families — “there were mixed reports about whether the office informed people if staff were running late... people and relatives in Bournemouth reported they sometimes had to phone the office.”
minorMissed or late visits — “sometimes the timings can go a bit awry if the first call in the morning is running late, followed by the lunchtime call running early as it could mean she has a late breakfast and then early dinner”
minorRecord keeping — “A person's prescribed creams and ointments frequently changed and were recorded in their daily notes rather than on their medicines administration record (MAR).”
Strengths
· People and relatives reported feeling safe and comfortable with staff who visited them
· Medicines generally managed safely with computerised recording system alerting office staff to missed doses
· No missed care visits and enough staff to provide people's care
· Robust recruitment checks including enhanced DBS checks
· Staff trained in safeguarding and understood their reporting responsibilities
Quality-Statement breakdown (8)
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuse; RecruitmentNot rated
safe: StaffingNot rated
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongNot rated
safe: Preventing and controlling infectionNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Duty of candourNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careNot rated