Jemis Care retained a Requires Improvement rating at this focused April 2023 inspection, with repeated regulatory breaches under Regulation 12 (safe care and treatment) for incomplete risk assessments and Regulation 17 (good governance) for ineffective quality assurance systems. Strengths included consistent, person-centred care delivery, safe recruitment, and a well-regarded, hands-on registered manager, with Effective and Responsive key questions both improving to Good.
Concerns (4)
criticalCare planning: “catheter care had not been identified as a risk and therefore lacked an assessment about the risks associated with catheter use and guidance for staff”
criticalCare planning: “provider had completed a risk assessment for pressure sores and identified the person was at high risk, but they had not completed a risk mitigation plan”
criticalGovernance: “quality assurance systems were not being operated effectively as demonstrated by shortfalls identified during the inspection”
moderateIncident learning: “issues were not identified by the oversight systems, they were not resolved promptly which meant people could be at risk because the quality assurance systems required improvement”
Strengths
· Safe recruitment procedures followed including DBS checks, references and identity verification
· Staff received appropriate training including catheter care, MCA, infection control and medicines
· Person-centred care with consistent staffing enabling relationship building and knowledge of preferences
· Registered manager approachable, hands-on and involved in day-to-day care and quality monitoring
· Effective infection prevention and control measures with appropriate PPE use
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
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
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 supportNot rated
well-led: Continuous learning and improving careRequires 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: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
Jemis Care, a small domiciliary care agency supporting two people, was rated Requires Improvement overall at its first inspection, with breaches of Regulations 12, 17 and 19 relating to risk management, governance and safe recruitment. While the service was caring with consistent staff who reflected service users' cultural backgrounds, risk assessments lacked mitigation plans, recruitment checks were incomplete, and care plans were not always person-centred.
Concerns (7)
criticalCare planning: “the records noted two people were at risk of falls but there were no risk mitigation plans. Another person had asthma but there was no information about how the condition affected them.”
criticalGovernance: “Systems had not been used effectively to assess, monitor and mitigate risks to the health, safety and welfare of people using the service. This placed people at risk of harm.”
criticalStaff competency: “The provider did not always follow safe recruitment procedures to help ensure new care workers were suitable for the work they were undertaking.”
criticalRecord keeping: “The second employee did not have any references. The registered manager said they had received a verbal reference from their last employer, but this was not recorded.”
moderateConsent / capacity: “In one person's record's their relative had signed care plans but there was no evidence the relative had lasting power of attorney (LPA), although the registered manger thought they had.”
moderatePerson-centred care: “one person was diabetic and required support with foot care but there was no guidance in the care plan around this.”
moderateEnd-of-life care: “End of life care was not an integral part of the care planning process. This meant the provider could not demonstrate people using the service were asked about their wishes and preferences regarding end of life”
Strengths
· Care workers provided consistency of care, with people supported by the same regular carers
· Staff team reflected the cultural backgrounds of people they cared for and could speak their first language
· People and relatives felt treated with dignity, respect and compassion
· Registered manager was accessible and responsive to concerns
· Appropriate infection prevention and control practices, including PPE provision
Quality-Statement breakdown (25)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the law
Good
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; supporting people to access healthcareGood
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 preferencesRequires improvement
responsive: End of life care and supportRequires improvement
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
well-led: Continuous learning and improving careRequires 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: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood