Date of Assessment: 14 May to 15 July 2025. Vermuyden Care Ltd is a domiciliary care service providing personal care to people in their own homes. The service supported people of all ages, with different health and care needs. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. Personal care indicates that a person requires help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection, the service supported 42 people, 39 of whom were receiving personal care. We undertook this assessment because we had not reviewed the rating of the service since 28 October 2021. At our last assessment the service was rated requires improvement. At this assessment the service has made improvements and the service is now rated good. This inspection covered all quality statements under the key questions Safe, Effective, Caring, Responsive and Well led. The provider had a good learning culture and people felt confident to raise concerns. People were protected and kept safe. Staff understood and managed risks. There were enough staff with the right skills, qualifications and experience to provide care and support to people. The registered manager made sure staff received training and regular appraisals to maintain high-quality care. Staff managed medicines well and involved people in planning any changes. People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. People had enough to eat and drink to stay healthy. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. People were treated with kindness and compassion. Staff protected people’s privacy and dignity and treated them as individuals and supported their preferences. The provider supported staff wellbeing. People were involved in decisions about their care and staff provided information in a way people could understand. People knew how to give feedback and were confident the provider took it seriously and acted on it. The members of the management team and staff had a shared vision and culture based on listening, learning and trust. The registered manager was knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. as. There was a culture of continuous improvement with opportunities and resources to try new ideas.
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run npm run etl:reports -- --location 1-8761652315.
Vermuyden Care, a domiciliary care agency supporting 35 people, was rated Inadequate overall at its first inspection in November 2020, with breaches across safety, consent, staffing, person-centred care and governance. Widespread failures included no staff training in medicines, infection control or safeguarding, no formal consent processes, unsafe recruitment practices, and a governance framework so inadequate the manager was unaware what audits were required.
Concerns (15)
criticalStaff training: “The provider's training records showed the only training care staff had been provided with had been within their induction. The induction had been led by the manager, who confirmed...they were not appropriately qualified to deliver training.”
criticalMedication management: “The provider's training matrix showed staff had received no training beyond their induction; the section...for medicines training was blank for all staff.”
criticalInfection control: “Staff had been carrying out personal care during a pandemic without appropriate training.”
criticalSafeguarding: “Some staff told us they had received no training in relation to safeguarding; the provider's own training records showed no staff had received safeguarding training.”
criticalConsent / capacity: “We asked the manager how they ensured people had consented to their care plans. They replied: "I'm still thinking about that."”
criticalCare planning: “People using the service did not have access to their care plans, and the manager confirmed people had not been involved in developing their care plans.”
criticalGovernance: “The manager told us they weren't sure what a manager or provider audit was, and was obtaining guidance from an external organisation regarding this.”
criticalRecord keeping: “Some people's care plans indicated staff were supporting them with medication, but they did not have medication administration records (MARs) in place.”
criticalStaffing levels: “We looked at five staff files and found shortfalls in three of them. Some staff only had one reference, and in one staff member's case this was from a friend.”
criticalLeadership: “The manager had been in post for five months at the time of the inspection site visit, but had not submitted an application to register with CQC.”
moderateSupervision / appraisal: “None of the staff we spoke with had received a one to one supervision with their manager...only three staff had received a one to one supervision.”
moderateIncident learning: “Records we were provided with indicated there had been two minor incidents in the month preceding the inspection. There was no information available about any lessons learned.”
moderateCommunication with families: “The manager told us they were not meeting the requirements of the Accessible Information Standards, and could not meaningfully describe what steps they intended to take.”
moderatePerson-centred care: “People's views and decisions about care were incorporated in their initial assessments, but they had not been involved in devising their care plans.”
minorCultural competency: “Care assessments we checked showed limited information about people's cultural needs.”
Strengths
· People using the service spoke positively about care staff, describing them as friendly, respectful and pleasant.
· PPE was available and plentiful for staff, with spot checks monitoring correct usage during care visits.
· An electronic visit monitoring system confirmed visits took place at the planned time and for the planned duration.
· Staff reported feeling well supported by the management team and enjoyed working at the service.
· The provider held records of compliments received, with relatives praising staff's caring approach.
Quality-Statement breakdown (20)
safe: Preventing and controlling infectionInadequate
safe: Using medicines safelyInadequate
safe: Assessing risk, safety monitoring and managementInadequate
safe: Staffing and recruitmentInadequate
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Learning lessons when things go wrongRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceInadequate
effective: Staff support: induction, training, skills and experienceInadequate
Vermuyden Care improved from Inadequate to Requires Improvement at this focused inspection, with Safe and Effective rated Good after previous breaches of regulations 11, 12, 17 and 19 were addressed. Well-led remained Requires Improvement as new governance systems needed embedding and concerns persisted around staff consistency, late/missed calls and office communication.
Concerns (5)
moderateStaffing levels: “Most people and their relatives told us there were issues with staffing levels and staff turnover. This had sometimes resulted in changes in the staff who provided people's care.”
moderateMissed or late visits: “In some cases, there had been issues with lateness, and rushed or missed calls.”
moderateCommunication with families: “Some people were unhappy about staffing, consistency of staff, and communication with the office.”
moderateGovernance: “Although, some improvements had been made relatively recently, they were on-going, and needed embedding into practice.”
minorConsent / capacity: “a written contract was in place, which included charges for the service. This was a long and complex document, which was not in an accessible format or language.”
Strengths
· New registered manager made significant improvements to systems of governance and oversight
· Safe recruitment processes now in place with appropriate pre-employment checks
· Medicines well managed with personalised plans and improved auditing
· Staff received appropriate training including infection control and MCA
· Risk assessments individualised, outcome-focused and clearly recorded
Quality-Statement breakdown (15)
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
safe: Using medicines safelyNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Learning lessons when things go wrongNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietRequires improvement
effective: Staff working with other agencies to provide consistent, effective, timely careGood
caring: Supporting people to express their views and be involved in making decisions about their careRequires improvement
caring: Ensuring people are well treated and supported; equality and diversityRequires improvement
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Meeting people's communication needsRequires improvement
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlRequires improvement
responsive: Improving care quality in response to complaints or concernsRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsInadequate
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
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Supporting people to live healthier lives, access healthcare services and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: How the provider understands and acts on the duty of candour; Working in partnership with othersNot rated