Blue Ribbon Community Care (Tyne and Wear) improved from Good to Outstanding overall at this February–March 2018 announced inspection, having successfully remediated a previous regulatory breach in medicines management. The service was distinguished by exceptionally caring staff, a strong and proactive registered manager, and outstanding leadership that placed people firmly at the heart of service delivery.
Concerns (1)
criticalMedication management: “arrangements for managing medicines were not always safe. Records did not always accurately account for the medicines staff had given to people. In particular, there were unexplained gaps in medicines administration records”
Strengths
· Medicines management improved to Good with accurate MARs, strengthened audits and regular competency checks following previous regulatory breach
· Staff described as highly caring, developing exceptional personal relationships with people, regularly going above and beyond stipulated duties
· Registered manager proactively attended multi-disciplinary team meetings and promoted joint working with external professionals
· Reliable and consistent staffing with flexible rotas enabling punctual visits and full call durations
· Outstanding quality assurance system with spot checks, periodic audits and regular consultation with people, relatives and staff
Quality-Statement breakdown (18)
safe: Medicines administrationGood
safe: Safeguarding and whistleblowingGood
safe: Staffing reliability and consistencyGood
safe: RecruitmentGood
safe: Risk assessmentGood
effective: Staff training, supervision and appraisalGood
effective: Mental Capacity Act compliance and consentGood
Blue Ribbon Community Care (Tyne and Wear) was rated Good overall following an announced inspection in December 2015, with care described positively by people using the service. However, a breach of Regulation 12 was identified due to unsafe medicines management, including gaps in MAR records, failure to supervise administration for people assessed as requiring full support, and inconsistent medicines audits.
Concerns (4)
criticalMedication management: “Medicines records did not accurately account for individual medicines given to people. We found unaccounted for gaps in medicines administration records (MARs) for three out of four people.”
criticalMedication management: “On four consecutive days the daily logs for the person stated 'left [the person's] tablets on the table for [the person] to take.'”
moderateRecord keeping: “Where staff members had used this code on the MAR, there wasn't always a full explanation in the daily log to explain the reason for its use.”
moderateGovernance: “The registered provider's approach to medicines audits was inconsistent. We saw a date and signature on some MARs to show they had been checked, whilst on others there was no signature.”
Strengths
· People gave consistently positive feedback, describing care as 'Excellent', 'Brilliant', and 'Fantastic'.
· Staff demonstrated a good understanding of safeguarding alerts, whistleblowing procedures, and how to report concerns.
· People were supported by a consistent staff team who were punctual and stayed for the full duration of visits.
· Staff had a good understanding of the Mental Capacity Act and supported people to make day-to-day decisions.
· Comprehensive induction programme including three shadowing sessions with experienced staff before independent working.
Quality-Statement breakdown (15)
safe: Medicines managementRequires improvement
safe: SafeguardingGood
safe: Risk assessmentsGood
safe: Staffing and recruitmentGood
safe: Incident and accident managementGood
effective: Staff training and inductionGood
effective: Mental Capacity Act complianceGood
effective: Nutritional supportGood
caring: People's experience of care
Good
caring: Dignity and respectGood
responsive: Care planning and needs assessmentGood