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Scott Care`s Medway Branch Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 18 April 2020

About the service

Scott Care’s Medway Branch provides personal care to older people living in their own homes. At the time of the inspection 180 people were using the service.

People’s experience of using this service and what we found

There were not always enough staff to keep people safe and meet their needs. People had not received visits, not always received their full visit or at the time they needed to meet their needs. This meant people had not received essential care and medicines. People and relatives told us they were not always informed if their carer was running late. Medicines were not managed safely as records did not make it clear what medicines were prescribed.

Reporting of incidents and complaints was unreliable and inconsistent. Not all complaints had been investigated and used to make improvements to people’s care. Missed visits had been an on-going concern and an action and development plan with new systems to prevent future reoccurrence had been completed. However, systems for managing these risks were ineffective and people had been placed at risk as a result.

The provider had not achieved an open and person-centred culture and had not ensured the delivery of high quality and safe care. Staff gave mixed feedback on the support they received from the manager and communications needed improvement. The provider lacked oversight of staff training and supervision records. People and staff were not engaged with the service. People told us they found it difficult to contact the office and their calls were not returned.

Lessons were not always learnt when things went wrong. Quality assurance systems were not used effectively and had not identified all the concerns we found at inspection. Feedback from surveys and complaints had not always been analysed to identify trends. Learning from these was therefore missed and the provider had failed to make necessary improvements.

People’s care was not always person centred and planned to meet their needs. Care plans lacked detail of people’s likes and dislikes. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

There was a lack of risk management around people’s individual needs. We have made a recommendation about this. Not all allegations of abuse had been reported to the manager and therefore not all had been investigated by the manager. We have made a recommendation about safeguarding policy and procedures. Safe recruitment systems were in place although some improvements were needed with obtaining professional references.

Feedback on whether staff were kind and caring was mixed. We have made a recommendation about reviewing people’s visit lengths and times to ensure people are treated with dignity and respect. People's communication needs were not always met. We have made a recommendation about the provision of accessible information.

Staff had not received training around all individual’s needs. We have made a recommendation about staff training. People had not always received consistent staff to meet their needs. Assessments lacked information about people’s choices. People did not always have choice and control over their care as they didn’t always receive their care at a time to meet their needs.

People’s end of life wishes were not always recorded. Therefore, staff did not have the guidance to support people in line with their wishes should an unexpected death occur. We have made a recommendation about the management of ‘Do Not Resuscitate’ orders.

Environmental risks to people were managed safely and people were protected from the risk of infection. Where staff prepared meals for people or assisted them to eat, they were aware of people's needs in relation to any associated risks. People were referred to appropriate health professionals and staff work

Inspection areas

Safe

Requires improvement

Updated 18 April 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 18 April 2020

The service was not always effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 18 April 2020

The service was not always caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 18 April 2020

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 18 April 2020

The service was not always well-led.

Details are in our well-Led findings below.