Sowa

During our assessment of this key question, we found medicines were not always well managed. Medications were not recorded safely and the systems in place did not allow for appropriate oversight. Risks to people were not always assessed and accurately recorded to inform staff on how to keep people safe. Incidents and accidents that occurred were not always known to the registered manager and there was a lack of evidence to show learning from incidents that had occurred. Relative’s said initial assessments were completed before people started to use the service to ensure their needs were fully met. However, we found some initial assessments had been completed by people not employed by the service which meant the registered manager did not have a good oversight these of care packages. People told us they felt safe, and staff supported them well. People told us the provider was approachable and felt their concerns were listened to. Staff told us they had enough time to travel between care visits and ensured all care tasks were completed. Relatives said staff were well trained and skilled in carrying out their role.

During our assessment of this key question, we found policies and procedures were in place to assess people's needs before they started using the service. However, some initial assessments had been completed by a person not employed by the service and therefore procedures not always followed. Some people using the service required decision specific mental capacity assessments and best interest decisions however, these had not always been completed in line with the Mental Capacity Act. In our conversations with people and relatives, no concerns were raised in this area and staff supported people to choose and be involved in their care, as much as possible.

During our assessment of this key question, we found staff promoted people's independence, choice and control. People were being supported by a regular staff team and relatives told us staff knew people well and were highly complementary of the care people received. We found improvements were required to ensure care plans and risk assessments were detailed and completed in line with people’s needs.

During our assessment of this key question, we found the quality-of-care records were not always consistent, but this did not affect the quality of care people received. Relatives provided positive feedback about the care received by their loved ones.

During our assessment of this key question, we found improvements were needed in management oversight and governance in relation to medicines management, quality of risk assessments, care plans and mental capacity assessments. This same issue had been identified at our last inspection. The provider’s oversight and governance failed to ensure systems and processes identified the improvements needed in the quality and safety of care being provided. The registered manager did not have a good understanding of the remit of care provided under the regulated activity of personal care and that a registered provider cannot delegate to other agencies to have oversight of the care being provided. We found the systems in place were not ensuring accidents and incidents happening during delivery of care were known or analysed by the registered manager. Relatives told us they felt able to raise concerns and that these would be acted upon. Staff told us they enjoyed working at the service and felt well supported by the registered manager. There were processes in place to support staff in having the skills they required to complete their work safely, and to continuously be supported via supervisions.