Note7 Jul 2023
Staff supported people to maintain independence, pursue interests and play an active role in their own health.
Note7 Jul 2023
Accidents and incidents were recorded, reported and investigated appropriately by the management team.
Note7 Jul 2023
The provider worked collaboratively with local commissioners, GP surgeries and the local authority.
Note7 Jul 2023
Staff felt managers were accessible, approachable and transparent; staff knew how to raise concerns.
Note7 Jul 2023
All staff had received infection control training and PPE was used effectively.
Note7 Jul 2023
All staff had received safeguarding training and could explain the process for raising concerns.
Note7 Jul 2023
Safe recruitment procedures were in place including DBS checks and evidence of conduct from previous roles.
Note7 Jul 2023
Staff promoted equality and diversity; people received kind and compassionate care and staff respected privacy and dignity.
minorrecord_keeping7 Jul 2023
A person was due to have their morning call at 9am, however, staff had arrived at 6:30am... audits had failed to identify a disparity between the time a staff member arrived and the scheduled time.
minormissed_or_late_visits7 Jul 2023
There had been times were staff were more than 30 minutes late to the agreed time. One person told us, 'I've had occasional missed calls'.
moderatesupervision_appraisal7 Jul 2023
Supervision records identified that some staff members had not received supervision for at least four months. This was not in line with the provider's policy.
moderateincident_learning7 Jul 2023
The management team had not analysed themes and trends in the accident and incident reports, and ensured measures were in place to reduce the likelihood of repeat events.
criticalgovernance7 Jul 2023
The registered manager had not established an effective system to enable them to ensure compliance with their legal obligations and the regulations. Regulation 17 (1, 2, a, b, c)
criticalcare_planning7 Jul 2023
Comprehensive care plans and risk assessments were not available for all people... this put people at risk of not receiving appropriate and safe care.
criticalcare_planning7 Jul 2023
People's risk assessments did not contain clear and detailed guidance for staff to protect people from the risk of harm.
criticalmedication_management7 Jul 2023
In four cases, the transcriptions did not specify the dose of medicine required. Failing to state the required dose on a MAR could put the person at risk of receiving the wrong dose.
criticalmedication_management7 Jul 2023
Individual protocols for the use of 'when required' (PRN) medicines were not available. This was a finding of the previous inspection.