Best Care 4 U Stanmore was rated Good overall following a May 2016 inspection, but received Requires Improvement for Safe due to two regulatory breaches: inadequate risk assessments failing to capture all individual risks, and gaps in medicines administration records combined with an absent medicines audit process.
Concerns (4)
critical
Care planning
: “some areas of potential risks to people had not been identified and included in the risk assessments. This could result in people receiving unsafe care”
criticalMedication management: “there were gaps in some of the MARs we viewed...The service did not have an effective medicine audit in place.”
moderateSafeguarding: “the majority of staff we spoke with failed to explain that they could report their concerns to local authority or the CQC”
minorRecord keeping: “we did not see evidence that the service analysed the information obtained from satisfaction surveys. The provider explained that they reviewed the satisfaction surveys but this was not documented.”
Strengths
· People and relatives expressed high satisfaction with care quality and consistency of care workers
· Staff received relevant training including moving and handling, safeguarding, dementia awareness, first aid and health and safety
· Regular supervision sessions and annual appraisals were in place for all staff
· Care plans were individualised and included mental capacity, consent, health needs, likes and dislikes
· Quarterly reviews with people and relatives to assess and monitor changing needs
Best Care 4 U Stanmore received a Good rating across all five key questions at its October 2018 KLOE inspection, with no breaches of regulation identified. The service demonstrated strong person-centred care, robust governance and quality assurance, consistent staffing, and positive feedback from people, relatives and staff.
Strengths
· People and relatives consistently reported feeling safe and satisfied with the care provided, with no complaints raised since the last inspection.
· Comprehensive and personalised risk assessments were in place, reviewed and updated when people's conditions changed.
· Medicines administration records were fully completed with no gaps, and a monthly auditing system was in place.
· People experienced consistency of care staff and had no concerns about punctuality or attendance.
· Robust safer recruitment processes including enhanced DBS checks, identity verification and written references.
This focused inspection of Best Care 4 U Stanmore confirmed the service had remediated breaches identified in May 2016 relating to risk assessments and medicines management. The service now meets Regulation 12 requirements and the Safe domain rating has improved from Requires Improvement to Good.
Concerns (2)
criticalMedication management: “there were some gaps in Medicines Administration Records (MARs) where the service had administered medicines but had not recorded this appropriately on the MARs”
criticalCare planning: “some risk assessments contained limited information and some areas of potential risks to people had not been identified and included”
Strengths
· Risk assessments reviewed and improved to include comprehensive detail about people's home environment and overall health
· MARs completed with no unexplained gaps following refresher training for all care support staff
· Monthly medicines audit introduced since previous inspection to assess and monitor medicines management
· Care plans now include clear instructions for completing MARs
· Service demonstrated sufficient action to meet Regulation 12 of the Health and Social Care Act 2008
Quality-Statement breakdown (1)
safe: Risk assessments and medicines managementGood