6 July 2021
During an inspection looking at part of the service
Scotland Road Branch provides personal care to people in their own homes. At the time of our inspection, the service was supporting 413 people.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Medicines were not always managed safely. Medication administration records (MAR) were not completed consistently to a high standard. There were no recent records of competency assessments for existing staff to ensure they were able to safely administer medicines.
Not all risks were assessed and mitigated to keep people safe from harm. Some risk assessments had not been completed and some were not detailed enough to guide staff to support people safely. This placed people at avoidable risk of harm.
Systems in place to monitor the quality and safety of the service were not always effective. Some of the recording issues found during this inspection had been identified by the providers systems. However, this had not always resulted in a sufficient and timely response to keep people safe.
Oversight of the safety and quality of the service was not always effective. There was no system in place to monitor staff’s completion of COVID-19 tests. This meant that the provider failed to identify that staff were not completing weekly COVID-19 tests in line with best practice guidance.
Staff followed good infection control practices and used PPE (personal protective equipment) to help prevent the spread of healthcare related infections. One person told us, “[Staff] always come in with masks, gloves and aprons.”
Staff were safely recruited and deployed in sufficient numbers to meet peoples care needs. A dedicated team monitored people’s call times and took action to follow up on late call alerts to ensure peoples care needs were met.
Staff were aware of procedures to follow if they had any safeguarding concerns. The registered manager had oversight of detailed records relating to safeguarding actions and outcomes.
Staff completed regular telephone reviews with people to gather feedback about the care provided. People also told us they received questionnaires. We received mixed feedback from staff in relation to engagement and the support they received. However, we saw evidence of regular staff engagement through team meetings, telephone job chats and appraisals.
The service worked with the local authority to coordinate the care and support people needed. Professionals who work with the service spoke positively about the working relationship and told us staff "try to work with us to get the best outcomes for members of the community." The registered manager acted in accordance with their duty and shared information in an open, honest and timely manner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 4 January 2018).
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
The provider responded to the concerns we raised during and after the inspection. They provided evidence of immediate improvements to their governance systems and updated risk assessments to mitigate the risks to people’s health and safety.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to the management of medicines and governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.