Care Solutions North Yorkshire was rated Good overall at this first inspection, with positive feedback on caring, person-centred and well-led care. Safe was rated Requires Improvement due to PRN medicines guidance gaps, incomplete MAR records, ineffective medication audits and missing fire risk assessments at the office.
Concerns (5)
moderate
Medication management
: “Guidance for staff around administering 'when required' (PRN) medicines, was not in place. This is not in line with best practice or the providers own policy.”
moderateRecord keeping: “MAR charts did not include stock numbers, application instructions for the use of topical medicines were missing, and variable dose medication was not recorded to indicate quantity given.”
moderateGovernance: “Medication audits had been developed to review the administration of medicines. These were not effective in highlighting gaps in recording or where 'best practice' was not followed.”
minorCare planning: “These were then further developed to reflect people's preferences and include person centred details. These were not always done in a timely manner following admission.”
minorOther: “Safety checks had been implemented and recorded for the office location however fire risk assessments and fire drills were not in place.”
Strengths
· Person-centred care plans reflecting people's preferences, likes, dislikes, social background and cultural needs
· Positive caring culture with staff going above and beyond (e.g. caring for a person's pet, buying flowers/cards)
· Strong staff training, supervision and competency checks supported by a training matrix
· Safe recruitment practices and sufficient staffing with monitoring by the registered manager
· Open, transparent leadership culture with reward schemes promoting high-quality care
Quality-Statement breakdown (25)
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentGood
safe: Learning lessons when things go wrongGood
safe: Preventing and controlling infectionGood
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
effective: Ensuring consent to care and treatment in line with law and guidanceGood
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: 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
responsive: Meeting people's communication needsGood
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
well-led: Continuous learning and improving careGood