Note18 Oct 2023
Two 'as required' medication protocols had been introduced since the previous inspection, representing some progress.
Note18 Oct 2023
One care plan identified as insufficient at the last inspection had been updated to include details of the person's medical conditions.
Note18 Oct 2023
Relatives praised the registered manager's honesty, intelligence and integrity, and the quality of care workers.
Note18 Oct 2023
One relative reported: '[Person] used to have pressure sores, they are cleared up now, they do a fantastic job.'
Note18 Oct 2023
Some relatives were very positive: 'The service is first class, carers turn up on time, they ensure flat tidy and clean and make beds.'
criticalrecord_keeping18 Oct 2023
There were no MAR charts, PRN records, body maps or cream charts for any of these people however, a relative told us, 'Staff administer creams...they fill in a chart.'
moderategovernance18 Oct 2023
The registered manager told us, 'I have done medication checks, I just haven't documented them.' Any checks undertaken had failed to identify the concerns we found.
criticalgovernance18 Oct 2023
Quality assurance audits were not in place for example, to check the quality and accuracy of care plans, risk assessments and medicines records.
criticalcare_planning18 Oct 2023
One person's care plan said they had a specific medical syndrome. There was no other information relating to this condition. We asked two staff members...they told us, 'I am sorry, I don't know.'
criticalcare_planning18 Oct 2023
Care plans continued to fail to contain enough information about people's specific medical conditions...one person's care plan identified they had chronic kidney disease stage three, however, there wa…
criticalstaff_competency18 Oct 2023
At the last inspection staff had not had their competency to administer medicines assessed. At this inspection staff had still not had their competency to administer medicines assessed.
criticalmedication_management18 Oct 2023
Where a medication had been reduced by a medical professional this had not been identified on the MAR chart...We have raised a safeguarding referral about this.
criticalmedication_management18 Oct 2023
'As required' medicines protocol guided staff to administer three different amounts...It was not clear what the prescribed dose was, or when it should be administered.
Note11 Nov 2022
The service was working within the principles of the Mental Capacity Act.
Note11 Nov 2022
Some systems were in place including staff supervision and reviews of people's care.
Note11 Nov 2022
A relative described staff as 'wonderful' and was 'very happy' with the service.
Note11 Nov 2022
Staff competency assessments for medicines administration had been completed since the last inspection.
Note11 Nov 2022
Staff had access to appropriate PPE and described wearing aprons, gloves and masks when visiting people.
Note11 Nov 2022
Safeguarding policy was understood by staff, and staff demonstrated sound understanding of safeguarding procedures.
Note11 Nov 2022
People were supported by a consistent staff team who knew them well, reducing the risk of unsafe care.
criticalleadership11 Nov 2022
The registered person did not demonstrate a robust understanding of how to comply with regulation and sufficient improvement had not been made.
minorperson_centred_care11 Nov 2022
the provider had not always acted on people's feedback to make improvements for them.
minormedication_management11 Nov 2022
The medicine record provided guidance about where on the body the cream should be applied but not how frequently. This meant there was risk the cream was not being applied at the times the person need…
moderateinfection_control11 Nov 2022
Staff were not testing for COVID-19 in line with Government guidance... detailed guidance about areas relating to COVID-19 such as testing and the use of PPE was not available.
moderatecare_planning11 Nov 2022
risk assessments had not been put in place regarding people's health conditions. These included conditions such cellulitis, chronic kidney disease stage three and diverticular disease.
moderaterecord_keeping11 Nov 2022
Records were not always detailed or up to date. This included people's risk assessments, care plans and medicine records.
criticalgovernance11 Nov 2022
The failure to have effective systems in place to assess, monitor and improve the quality and safety of the service and to maintain accurate and complete records was a continued breach of Regulation 1…