Care Solutions Fylde Limited improved from Requires Improvement to Good across all five key questions, having remediated previous breaches of Regulations 12 and 17 regarding medicines management, risk assessment, and governance. The service demonstrated consistent, person-centred care delivery underpinned by strong leadership, effective use of electronic care planning, and a committed staff team.
Strengths
· Medicines management significantly improved since previous inspection, with staff trained, competency-assessed, and thorough records maintained
· Consistent staffing teams assigned to people, with geographical rotas and timely communication about delays
· Positive, person-centred culture fostered by manager, with strong feedback from people, relatives and staff
· Electronic care planning system enabling real-time monitoring and instant updates to staff via smartphone app
· Robust safeguarding, recruitment checks including DBS and references, and a probationary period for new staff
Quality-Statement breakdown (23)
safe: Using medicines safelyGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
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: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversity; privacy, dignity and independenceGood
caring: Supporting people to express their views and be involved in making decisions about their 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 supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
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
Care Solutions Fylde Limited was rated Requires Improvement overall at its first CQC inspection, with regulatory breaches identified in safe care and treatment (Regulation 12) and governance (Regulation 17), relating to inconsistent risk and medicines management and ineffective quality assurance systems. The service was rated Good for caring, with people speaking positively about staff attitudes and dignity, but significant concerns remained around late visits, incomplete care plans, absent medicine audits, and the lack of a registered manager.
Concerns (11)
criticalCare planning: “Not all care plans had guidance and strategies for staff on how to identify and manage health risks, such as type 2 diabetes and epilepsy.”
criticalMedication management: “The provider had not completed any recent medicine audits, or competency checks on staff. One person's medicine administration recording sheet did not identify they were allergic to one medicine.”
criticalGovernance: “Not all quality assurance activities were consistently completed or effective. They had not identified the shortfalls we found during our inspection.”
criticalRecord keeping: “Accurate and contemporaneous records related to each service user, persons employed, and the management of the service had not been kept.”
moderateMissed or late visits: “The teatime visit is often very late, it should be 4 pm but has been 6-6.30pm.”
moderateLeadership: “The service did not have a manager registered with the Care Quality Commission as required by law at the time of our inspection.”
moderateStaff competency: “Three staff we spoke with could not explain what one of the conditions were, or how these conditions impacted on the person's life.”
moderateInfection control: “We were not assured that the provider was using PPE effectively and safely as we received conflicting information.”
moderateComplaints handling: “We asked about additional complaints we were aware of. The regional manager said these were stored in personnel files and would submit them. These were never received.”
moderatePerson-centred care: “One person said, 'I haven't seen a care plan I think they learn what my needs are by word of mouth to be honest.'”
minorEnd-of-life care: “Care plans did not identify if people had a DNACPR in place and where it was stored. The provider did not discuss preferred places of care or advanced care planning.”
Strengths
· Staff were described as caring, respectful and dignified by people using the service, with positive feedback including 'They are respectful of my dignity' and 'They are very friendly, helpful and respectful.'
· Staff had received safeguarding training and knew how to report allegations to external agencies.
· The service worked in partnership with healthcare professionals and other agencies to ensure coordinated care.
· People and staff expressed confidence in the new management team and noted the service was improving.
· All staff participated in weekly COVID-19 testing and were being encouraged to receive the vaccine.
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Preventing and controlling infectionRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Learning lessons when things go wrongGood
effective: Supporting people to eat and drink enough to maintain a balanced dietRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the law
Requires improvement
effective: Staff support: induction, training, skills and experienceGood
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
caring: Ensuring people are well treated and supported; respecting equality and diversity; Respecting and promoting people's privacy, dignity and independenceGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesRequires 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 concernsRequires improvement
responsive: End of life care and supportRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careRequires 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 staff; Working in partnership with othersGood
well-led: How the provider understands and acts on the duty of candourRequires improvement