During an assessment under our new approach
Oswestry, known as Approved Care and Support providesdomiciliarycare. The service is registered to provide personal care to adults and older people living in their own homes, includingpeople with physical disabilities, learning disabilities,mental health conditions, sensory impairments, dementia,eating disorders,andsubstance misuse problems. Not everyone who uses the service receivepersonal care. CQC only inspects where people receive personal care. This is to help with tasks related to personal hygieneand eating.At the time we started our assessment, the servicewasproviding support to70peopleacross Oswestry and Shrewsbury.The provider has2registered managers, each responsible for overseeing service delivery within their respective area.
We gave the service 48 hours’ notice of the inspection. This was because we needed to ensure the managers would be onsite when we visited.The inspection was responsive as thepreviousinspection had taken place 5 years earlier in 2020.The inspection was carried out by 2 inspectors and 1 regulatory coordinator.The inspectors carried out a sitevisit on9 December 2025. The regulatory coordinator spoke with staff and people who use the service, over the telephone.Following the office visit we continued to seek clarification from the provider tovalidateevidence found. We looked atinformation sent to us by the provider, in response to the findings of the site visit. We also contacted health and social care professionals who work with the service foradditionalfeedback.
At the last inspection we found care plans did notcontainclear guideline for carers to support people with specific health conditions, at this inspection we found the provider had not fully addressed this.
There were sufficient staff to meet people’s needs, and no reports of missed calls wereidentified. We found improvements in the consistency of staff teams. Robust induction and annual refresher training systems were in place; however, there were no systems to check staff competencies in medicineadministration following training. This meant we could not be assured all staff were competent to administer medicinessafely.
Additionally, we found staff had not completed some health-specific training, including autism awareness, which is a legal requirement for all regulated providers. As a result, we could not be confident that staff were fully trained and competent to deliver care that meets people’s individual needs.
Weidentified6incidents that, in line with CQC registration requirements, should have been notified to CQC. These notifications, which included safeguarding concerns and the deathsof service users, are legally required so that CQC canmonitorservice performance, assess the safety and quality of care, andmaintainregulatory oversight. These notifications were notsubmittedat the time of the incidents. During the inspection process, the registered manager took steps tosubmitthe required notifications.
The registered managerswereresponsive to feedback from CQC and have taken initial steps to implement improvements. Actions includedensuringappropriate healthcarerisk assessments and plans are in place, sourcing and delivering health-specific training, and developing robust systems tomonitorstaff competencies following training.
We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices,independenceand good access to local communities that most people take for granted.
We gathered information from people who used the service, relatives, the registered manager, care staff, and health and social care partners.
The provider was in breachof legalregulationsrelating to safe care and treatment andgood governance.
We have asked the provider for an action plan in response to concerns found at this assessment.