First inspection of this newly registered domiciliary care agency providing mainly palliative and end of life care to nine people, rated Good across all five key questions. Minor recommendations were made around record keeping, spacing of training, recruitment references and developing equality/diversity assessments as the service grows.
Concerns (6)
minor
Medication management
: “one person's medicines had been missed on one occasion. This was because the carer who attended to a person's call had not been medicine's trained”
minorRecord keeping: “the records had been archived... the detail of the investigation was not easily accessible. The registered manager agreed more comprehensive records would be kept”
minorRecord keeping: “daily records were task oriented and did not always refer to people's wellbeing”
minorStaff training: “Staff training was carried out intensively often on one or two days, we recommended spacing this out to give opportunities to check staff understanding”
minorStaff competency: “ensuring a risk assessment was carried out if references could not be obtained from previous employment. In addition, making sure references were from employers rather than work colleagues”
minorCultural competency: “People were asked if they had any specific needs in relation to culture, faith or sexuality. The registered manager acknowledged that this was an area that could be improved upon”
Strengths
· Regular staff who arrived on time and stayed the allocated call duration
· Safe medicines management with monthly audits and competency assessments
· Strong palliative and end of life care with positive relative feedback
· Open, positive culture with accessible registered manager who leads from the front
· Safe recruitment including DBS and reference checks
Quality-Statement breakdown (21)
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standardsNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Continuous learning and improving care; Working in partnership with othersNot rated