Metro Homecare Ltd received an overall rating of Requires Improvement at its first CQC inspection, with breaches of Regulation 12 (Safe Care and Treatment) and Regulation 17 (Good Governance) due to incomplete risk management plans and ineffective quality monitoring systems. Responsive care was rated Good, with person-centred care planning, strong complaints handling, and positive feedback from people and relatives, though governance failures must be addressed to ensure sustained safety.
Concerns (4)
criticalCare planning: “some risk assessments did not include a risk management plan or guidance for staff to follow to help ensure they understood the person's condition and knew how to meet their needs”
critical
Governance
: “monitoring systems had not always been effective and had failed to identify the issues we found in relation to risk management plans not being in place”
moderateIncident learning: “three incidents recorded in June 2019 and one in June 2018 did not contain details of investigations, actions taken, or lessons learned”
moderateRecord keeping: “risk reduction measures only stated, 'Not changed on time and does not like being too hot'. There were no guidelines for staff to recognise signs of skin deterioration”
Strengths
· People felt safe and well cared for, trusting care workers and the management team
· Sufficient staffing levels maintained, including bank staff to cover pandemic-related absences
· Medicines administered safely with regular audits of MAR charts and prompt corrective action
· Comprehensive, person-centred care plans covering all aspects of individual needs and preferences
· Strong complaints handling with prompt and responsive office staff
Quality-Statement breakdown (14)
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving care; Working in partnership with othersGood
Metro Homecare Ltd improved from Requires improvement to Good across all five key questions, addressing previous breaches of regulations 12 and 17. The service demonstrated safe, person-centred care with robust governance, though daily log notes lacked detail on the social aspect of visits.
Concerns (1)
minorRecord keeping: “this did not always come across in their notes, as these lacked details about the social aspect of the visits. We fed this back to the registered manager”
Strengths
· Improvements made since last inspection; no longer in breach of regulations 12 and 17