Total Case Management, a domiciliary care agency specialising in acquired brain injuries, received a Good rating across all five key questions at its first inspection in November 2021. The service demonstrated strong person-centred care and effective multi-agency working, with a minor recommendation to improve MCA record-keeping practices.
Concerns (3)
moderate
Consent / capacity
: “records did not always reflect the MCA processes had been followed. The provider and registered manager had already identified this gap and work in this area was ongoing.”
minorStaffing levels: “agency care staff were consistently used to ensure staffing levels remained sufficient to meet people's needs.”
minorInfection control: “Staff completed weekly COVID-19 tests however, the type of test used was not always in line with current government guidance.”
Strengths
· Care plans and risk assessments were thorough and gave staff detailed guidance on how to keep people safe from avoidable harm.
· People were fully involved with the selection of their staff team, including attending interviews of potential staff.
· Staff received training and competency checks to ensure they administered medicines in line with best practice standards.
· Innovative methods introduced to encourage independence, such as use of Neater Eater assistive technology.
· Assistive technologies used effectively to allow people with limited verbal communication to express their views.
Quality-Statement breakdown (19)
safe: Preventing and controlling infectionGood
safe: Staffing and recruitmentGood
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongGood
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuseGood
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 diet; Staff working with other agenciesGood
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: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
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 staff; Continuous learning and improving careGood