Date of Assessment: 12 March to 21 March 2025. CARE4U office is a homecare service, which provides personal care for people living in their own homes. At the time of the inspection 8 people used the service. At the last inspection we identified a breach of regulation in relation to the oversight of the service. Quality assurance processes were not effective at ensuring care and medicine records were up to date and maintained in line with best practice guidance. Audits had not identified the issues. At this inspection, improvements had been made, and the service was no longer in breach of regulations. Staff knew how to provide safe care. They understood people's needs and how to manage any presenting risks. The provider ensured the assessments were completed in a timely manner and were accurate. The care records clearly detailed people’s needs and were written in a person-centred manner. The provider promoted a learning culture where staff had access to a wide range of training, which equipped them with the skills and knowledge to work well with people. As part of the staff induction programme, the staff from overseas completed learning about preparing and cooking nutritious meals, which were culturally appropriate for the people they supported. Staff found the training really supported them to provide the best care possible for the people who used the service. The provider ensured the service put people first. They encouraged people to share their views and always looked to see what improvements could be made. The provider ensured there were enough staff available to deliver the care packages. On the whole recruitment practices were meeting requirements. We discussed the need for application forms, and interview questions to cover all employment history, which the provider immediately actioned. Staff consistently reported the provider was approachable and really encouraged them to go the extra mile.
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Care4u Office, a domiciliary care agency supporting eight people, was rated Requires Improvement overall at its first inspection due to unsafe medicines management and ineffective quality assurance, both breaches of Regulation 17. Effective, caring and responsive domains were rated Good, with positive feedback on staff kindness, training and person-centred support.
Concerns (7)
criticalMedication management: “Medicines were not always managed safely. Medicine administration records were not maintained in line with best practice guidance.”
criticalGovernance: “Quality assurance processes did not take place effectively for care and medicine records. Some care plans were good but others were inconsistent or out of date.”
criticalGovernance: “Medicine audits were not carried out.”
moderateMedication management: “'As and when required' medicines were not clearly recorded in medicine records and did not include instructions about when these medicines should be given.”
moderateRecord keeping: “There were gaps in people's medicine records which the provider confirmed was staff forgetting to sign.”
minorCare planning: “some care plans were out of date. As the staff team was very small, staff knew the people they cared for well and their care was not impacted.”
minorIncident learning: “Lessons learnt were shared with staff via a secure messaging service, however they were not formally recorded.”
Strengths
· People felt safe with their carers and safeguarding systems were in place
· Staff were recruited safely with DBS checks completed
· Staff received regular training, supervision and appraisal
· People received personalised, compassionate care and warm relationships with staff
· Provider followed MCA principles and sought consent before care
Quality-Statement breakdown (22)
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongGood
safe: Staffing and recruitmentGood
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: 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: 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 supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
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