Aldanat Care retained an overall Good rating following a focused inspection triggered by concerns about closed culture and safeguarding risks, with no evidence found of actual harm to people. The Safe domain was downgraded to Requires Improvement due to staff not consistently following least-restrictive restraint guidelines, gaps in incident capture, and recurring medicine administration record issues.
Concerns (6)
critical
Safeguarding
: “we found examples where staff did not follow these guidelines and it resulted in people being unnecessarily restrained and, in some cases, not in line with safe practices.”
moderateIncident learning: “The registered manager did not always capture incidents relating to restraint and how any lessons learnt that is identified is shared with the relevant people to drive change and improvements.”
moderateMedication management: “Records and trends picked up by the management team showed that there were consistent areas of improvement in the signing of the medicine administration records.”
moderateCare planning: “In some cases, there were restrictions in people's homes without adequate justification as to if this was the least restrictive measure.”
minorCommunication with families: “Professionals spoke highly about the responsiveness of staff, however they felt that the communication with the management needed to improve.”
minorGovernance: “the registered manager was going to develop the system they already had and incorporate these areas into themes and trends to drive change.”
Strengths
· Staff supported people to play an active role in maintaining their own health and wellbeing and enabled people to access specialist health and social care support in the community.
· People were involved in the recruitment process to select staff with the right skills and personalities.
· Staff were knowledgeable about the Mental Capacity Act and applied it in practice to promote choice and least restrictive support.
· The registered manager had quality assurance systems in place that reliably identified areas for improvement.
· Staff felt well supported by management and reported a positive ethos within the service.
Quality-Statement breakdown (15)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongRequires improvement
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
effective: Ensuring consent to care and treatment in line with law and guidanceGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Working in partnership with othersRequires improvement