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Archived: Keystone Healthcare Limited

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Inspection report

Date of Inspection: 18 November 2013
Date of Publication: 18 December 2013
Inspection Report published 18 December 2013 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 18 November 2013, talked with people who use the service and talked with carers and / or family members. We talked with staff.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

During our visit we looked at the care records of four people using the service. The records were maintained using the provider’s computer system, with documents then being printed and kept as hard copies. The manager told us people’s care and support needs were reviewed at least annually, which, where required, included the input of family and other professionals. We found that some care plans appeared not to have been reviewed for at least one year. We spoke with the care coordinator about this and they confirmed these care plans had been reviewed but that an updated version had not been printed to be kept in the office. They explained that the functions and use of the company’s computer system was being reviewed by the provider. This was confirmed by discussions we had with the IT manager during the visit.

People’s care plans and risk assessments were up to date and, should people using the services’ care needs change, the plans were reviewed to reflect this. The documents were concise and easy to use and understand. The care plans set out the support people received and the timing of visits. We found that smoke alarm and carbon monoxide tests were carried out each month in people’s homes. Each person’s care plan also had a ‘home risk assessment’ in place; including the location of the stop tap and electrical trip switch. This showed the service had considered the safety and welfare of the people using the service in their own home.

Care plans that we looked at were comprehensive and personalised, including full routines, care and support provided for each call and any other person-specific information. We also saw there was an ‘Emergency Carer’s Support Plan’ in place in one file. This was for use if the private carer employed by the person using the service was unavailable. This showed the service had plans in place for maintaining service continuity to people.

We saw that daily log books were filled in correctly after every visit made by the support workers. These included the time the support worker arrived and the time they left. However we found that medication administration records, known as MAR sheets, were not always filled in correctly. We saw there were some gaps in the records of medication identified but no explanation was given. We spoke to the manager about this, who told us that support workers always administered people’s medication using dosette boxes. Dosette boxes are boxes that contain medications organised into compartments by day and time, so to simplify the taking and administration of medications. The manager said they would remind staff about the importance of ensuring medication records were filled in correctly for all the people they administered medication to.