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Inspection report

Date of Inspection: 31 October 2012
Date of Publication: 29 November 2012
Inspection Report published 29 November 2012 PDF

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

Not met 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, reviewed information sent to us by other organisations, carried out a visit on 31 October 2012 and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members, talked with staff and talked with stakeholders.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights, however care plans did not always show the current care needed.

Reasons for our judgement

Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare.

People told us they were happy with the care provided. One person said, "99% of the time the care has been brilliant", and other person said, "At the end of the visit (my relative) always looks well." In the office we saw compliment cards and letters sent from people who had previously used the service. These comments included, "An excellent service. Staff showed 100% commitment" and "(my relative) always looks forward to seeing the carers."

We looked at the care records of four people who were using the service. The records showed us that an assessment and plan of care had been written with the person before the service started. The plans did cover the basic elements of each visit, but we found that each person had specific needs which included their mental well being, catheter care and managing the risk of sore skin. These had not been included in the plans. We asked the staff who supported these people about these needs. They showed a good understanding, which meant that despite the poor care plans, people were still receiving good care for long term, and known needs.

We found from reading people's daily care notes that short term changes in people's care needs were not being detailed on the care plans. We found some people had used the service for some time, and we noted that care needs on updated records were not always transferred accurately. We could not confirm with the registered manager what one person's current needs were, and which of the two different records contained the correct assessment of their needs. This increased the risk of a care need being unmet, or not met in the way the person wished or needed.

We looked at the plan of one person who required help with moving. This activity was assessed as needing two staff, a hoist and slide sheets. The care plan we looked at to support this need did not show how this activity was to be undertaken. The careplan did not direct two staff to work together. Notes showed staff were working individually. This could place the person at increased risk of harm during this activity.

Each person's care plan stated the time that visits should take place. Looking at staff rotas and log sheets we found that people were receiving their care and support close to the time they requested. We asked people about this and were told, "I have never had a missed call" and "I am happy with the time my carer comes to me."

Some of the people we tracked needed staff to support them with their medication. We found for some people the support required exceeded "prompting" and included pouring out doses of liquid medicines, handing people tablets and signing a medication record sheet. Whilst this is permissible within the regulations for medicines to be adminsitered this was not in line with the organisations own policy, or the training that staff had received. The support people needed with their medication was not always detailed in the care plan.