ReadyCQC, a weekly field guide to CQC home-care regulation

Inspection report · 2020-01-29

Framework: KLOE · 11 pages · 69 KB · PDF

Requires improvement

safe: Requires improvementeffective: Goodcaring: Goodresponsive: Goodwell-led: Requires improvement

Sunrise Day Care Services Ltd received an overall rating of Requires Improvement at its June 2017 inspection, with breaches of Regulation 12 (safe care and treatment) and Regulation 17 (good governance) due to inadequate risk assessments, outdated care plans, poor medicines recording, and failure to maintain staff training records. The service performed well in caring and responsiveness, demonstrating strong cultural and linguistic matching of staff to a South Asian client group, consistent staffing, and positive feedback from people and relatives.

Concerns (5)

criticalCare planning: “risk assessments and care plans were not regularly updated in line with changes in people's needs. Care records were not sufficiently detailed to provide an accurate account of the level of support people required.”
criticalRecord keeping: “The provider was in breach of Regulation 17 of the HSCA 2008 (Regulated Activities) Regulations 2014. Accurate and complete records were not maintained in regards to people's care and staff training.”
criticalGovernance: “the provider did not have robust systems in place to check the quality and completeness of care records.”
moderateMedication management: “People's care records did not state what medicines people were taking, when they should be taken and what dose. Therefore there was a risk that staff could not adequately check or prompt people to take their medicines.”
moderateStaff training: “staff's records did not contain any information about training completed since January 2016...no records were currently kept of the in-house training provided.”

Strengths

· Consistent staff allocated to individuals, with staff matched by language and cultural background to meet communication needs of South Asian community.
· Sufficient staffing levels with staff attending visits on time and staying the required length of time.
· Robust recruitment procedures including references and criminal records checks.
· Staff aware of safeguarding responsibilities and procedures; safeguarding policy updated.
· Staff received regular supervision providing opportunity to review performance and identify training gaps.

Quality-Statement breakdown (17)

safe: Risk assessment and managementRequires improvement
safe: Medicines managementRequires improvement
safe: Staffing levels and deploymentGood
safe: Recruitment practicesGood
safe: SafeguardingGood
effective: Staff training and skillsRequires improvement
effective: Supervision and supportGood
effective: Mental Capacity Act complianceGood

Inspection report · 2019-06-21

Framework: KLOE · 16 pages · 82 KB · PDF

Requires improvement

safe: Requires improvementeffective: Requires improvementcaring: Goodresponsive: Requires improvementwell-led: Inadequate

Sunrise Day Care Services Ltd received an overall rating of Requires Improvement at its April 2019 inspection, with Inadequate for well-led, reflecting repeated breaches of Regulations 17 and 18 relating to poor governance, out-of-date care records, and staff lacking adequate training and safeguarding knowledge. Caring was rated Good, with people and relatives providing positive feedback about staff kindness, cultural sensitivity, and respect for dignity and independence.

Concerns (8)

criticalCare planning: “People's care plans had not always identified people's health conditions, communication, nutritional and mobility needs which meant that staff were not provided with guidance to ensure safe care delivery.”
criticalGovernance: “There were no quality assurance processes in place to review the quality of people's care records and to identify improvements required.”
criticalStaff training: “Staff last completed manual handling and first aid training courses in 2015. This time the registered manager told us that staff were booked to complete these courses at the end of April 2019.”
criticalStaff competency: “All three staff that we spoke to could not tell us what the MCA was about… two out of three staff could not tell us what types of abuse they should look out for.”
criticalSafeguarding: “Staff's understanding about safeguarding and the Mental Capacity Act 2005 (MCA) was limited and some of the training refresher courses had not been delivered since 2015.”
criticalRecord keeping: “Risk assessments had not identified individual risks to people in relation to their mobility, nutrition and daily activities. Information was not available on how to mitigate the potential risks.”
moderateLeadership: “The registered manager was only aware of death and safeguarding related statutory notifications that they had to submit to CQC.”
minorEnd-of-life care: “Care plan's continued lacking information related to people's cultural and religious needs and their end of life wishes.”

Strengths

· People told us staff were caring and kind, with positive feedback from people and relatives about dignity and respect.
· Staff were aware of people's cultural and religious needs and supported people accordingly, including meal preparation and dress.
· Staff supported people to express choices and maintain independence, respecting individual preferences including gender of carer.
· Confidentiality principles were applied with password-protected electronic records and locked care plan storage.
· People reported timely visit attendance, with one person stating 'Timing is brilliant. I had the same [staff] for years.'

Quality-Statement breakdown (22)

safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement

Inspection reports (4)