Immediate Quality Care (IQC) LTD improved since its previous inspection and is no longer in breach of regulations 12 and 17, achieving an overall Good rating. Well-led remained Requires Improvement due to minor governance gaps, delayed CQC notification of a safeguarding concern, and a management team still developing experience in running a care service.
Concerns (5)
moderate
Governance
: “the service had managed a safeguarding allegation effectively and could show lessons learnt across the team, but had delayed in notifying CQC in a timely manner.”
moderateLeadership: “The management team consisted of three staff, all of whom had a background in care, but not of management of a care service. They were developing experience in managing the service.”
minorCare planning: “We found one lacked detail regarding overall risk management of a person living at home alone with a cognitive impairment, and another which lacked detail regarding the person's consistency for fluid.”
minorRecord keeping: “Care plan documentation addressed how people communicated. We found one care record that needed more detail and this was updated following the inspection visit.”
minorStaff competency: “We noted there was not always references from previous employers who were social care providers. We discussed this with the management team who told us they had sought references and they had no response.”
Strengths
· Risk assessments now in place covering moving and handling, skin integrity, health conditions and the environment
· Safe medicines management with training, competency observations and monthly audits
· Person-centred care plans documenting needs, preferences, routines and cultural/religious needs
· Consistent staff team with people reporting rare missed or late calls
· Mental capacity assessments completed and LPA documented where applicable
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuse; Learning lessons when things go wrongGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
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: Supporting people to develop and maintain relationships to avoid social isolationGood
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 requirements; duty of candourRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement
well-led: Engaging and involving people using the service, the public and staffRequires improvement
well-led: Continuous learning and improving care; Working in partnership with othersRequires improvement