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Inspection summaries and ratings from previous provider

Overall summary & rating


Updated 10 June 2017

This inspection took place on 17 May 2017. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to ensure that the registered manager would be present to provide the information and documents necessary for the inspection.

During the last inspection on 18 January 2016 we found the service was in breach of two legal requirements and regulations associated with the Health and Social Care Act 2008. We found that there were no medicines audits in place across the service, care staff did not have one to one supervision sessions and annual appraisals were not sufficient to support staff to carry out duties they were employed to perform.

Medstar Domiciliary Care service provides care and support for 11 people. Medstar works with people living with dementia, learning disabilities, people with autistic spectrum disorder, and people with sensory and physical impairment.

People and relatives told us they felt safe. Procedures and policies relating to safeguarding people from harm were in place and accessible to staff. All staff had completed training in safeguarding adults and demonstrated an understanding of types of abuse to look out for and how to raise safeguarding concerns.

Detailed and current risk assessments were in place for people using the service. Risk assessments were reviewed and updated regularly. Risk assessments explained the signs to look for when assessing the situation and the least restrictive ways of mitigating the risk based on the individual needs of the person whilst supporting them to be independent.

Medicines were now managed safely and effectively and there were regular medication audits in place. Staff had completed medication training and the service had a clear medication policy in place which was accessible to staff.

Staff were now receiving regular documented supervisions and an annual appraisal. We saw evidence of a comprehensive staff induction and on-going training programme. Staff were also safely recruited with necessary pre-employment checks carried out.

We received positive feedback from people and relatives regarding the caring and supportive nature of staff.

Care plans were person centred and reflected what was important to the person. Care needs were regularly reviewed and updated to meet the changing needs of people who used the service.

We saw evidence of a comprehensive and on-going training programme.

All staff had received training on the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) and staff understood what to do if they had concerns with regards to people's mental capacity.

People were supported to maintain good health and had access to healthcare services.

The service regularly requested feedback from people who used the service.

People were encouraged and supported to access the community and engage in activities of their choice.

The management team enabled an open culture that encouraged staff to discuss issues and areas for improvement.

The provider had a quality monitoring system to ensure standards of service were maintained and improved.

Inspection areas



Updated 10 June 2017

The service was now safe. Medicines were safely managed.

Procedures were in place to protect people from abuse.

Risks to people who used the service were identified and managed appropriately.

There were sufficient staff available to ensure that people's needs were met.



Updated 10 June 2017

The service was now effective. The service was now carrying out supervisions and appraisals, with staff, on a regular basis. Staff had access to regular training to carry out their role.

People were given the assistance they required to access healthcare services and maintain good health.

Mental capacity and Deprivation of Liberty safeguards were understood and principles of the code of practice were being followed.



Updated 10 June 2017

The service was caring. We received positive feedback from people and relatives regarding the caring and kind nature of staff.

People were treated with dignity and respect.

People were supported to develop and maintain independence.



Updated 10 June 2017

The service was now responsive. Care plans were person centred and reviewed regularly with the involvement of people and relatives.

People were supported to engage in a variety of activities.

The service had a complaints procedure in place and requested feedback from people, relatives and professionals.



Updated 10 June 2017

The service was now well led. The quality of the service was monitored.

Relatives and staff spoke positively about management and how they were supported.

The service had a positive open culture which continuously strived to improve.