15 April 2019
During a routine inspection
People’s experience of using this service:
The measures put in place to protect people from harm were not always robust. Information about risks associated with care and support needs was not always documented, call management lacked oversight and control, and there were persistent errors in the recording of medicines that people had been given. People’s complaints were not well managed. We made a recommendation about improving staff knowledge about reporting concerns about people’s safety.
People said they got on well with staff, and said they felt staff were mindful of their dignity and privacy. Staff were recruited safely and used appropriate protective equipment such as gloves and aprons. Staff had formal and informal support and there was a programme of training in place. We made a recommendation about improving the content of one piece of training.
People said they were offered choice and asked for consent, however we found some issues with documentation about decision making.
Care plans were brief and lacked evidence people were involved in writing them. Information about how people were supported to remain independent was lacking. There was no information about the kind of additional support people may need at the end of their lives.
We identified two breaches of regulation relating to person-centred care and safe care and treatment.
The processes to monitor and measure quality in the service were weak. When issues were found the action taken as a result did not always resolve them. There was a lack of drive to involve people and staff in the running of the service.
Rating at last inspection: This was our first inspection of the service since the change of provider in 2018.
Why we inspected: This was a planned inspection based on the date of registration.
Enforcement: Please see the ‘action we have told the provider to take’ section towards the end of the report.
Follow up: We have asked the provider to send us an action plan to show how the required improvements will be made. We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk