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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

The service should have quality checking systems to manage risks and assure the health, welfare and safety of people who receive care (outcome 16)

Not met this standard

We checked that people who use this service

  • Benefit from safe quality care, treatment and support, due to effective decision making and the management of risks to their health, welfare and safety.

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

The provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

Reasons for our judgement

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

People we spoke with confirmed that staff from the office would sometimes ring them, and check they were happy with the care being offered. People told us, "I get the odd call to ask how things are" and "Yes. I have had a call to check if things are alright." In people's care notes we saw records of calls and sometimes face to face meetings of these quality checks. We were informed that the information collected had not been collated to ensure that any themes or trends were identified and acted upon.

We tracked the action taken by the registered provider in response to a complaint made by a person using the service. We could see that the person had been kept updated about the action being taken, and a letter sent when the investigation was concluded. Notes of the investigation showed that the matter was thoroughly explored.

The registered manager reported that no accidents had been logged since the agency opened.

We asked to see a record of incidents such as falls, or difficult incidents. We were advised by the registered manager there had been none and no record existed.

The provider may find it useful to note that the checks in place at the time of our inspection had not been entirely effective at picking up issues and shortfalls.