Home Healthcare Delivery - Prescot

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.

Right Support: Specific training was provided to ensure staff had the required skills to support people with a learning disability and autistic people.

Right Care: Staff were person centred in their approach which promoted people's privacy and dignity. However, positive behaviour support plans required more detail to guide staff in effectively supporting people.

Right Culture: Leaders lacked awareness of 'right support, right care, right culture' guidance.

People were exposed to avoidable risk of harm as systems to ensure the safe and proper management of medicines were inadequate. Medicines to reduce the risk of skin deterioration were not always given as prescribed. This placed people at increased risk of skin breakdown and poor health outcomes. Not all staff had their competency to administer medicines assessed in line with best practice guidance.

Not all records demonstrated risk was effectively assessed, monitored or mitigated. Lessons were not always learnt. The provider took some action to reduce the risk to people following recent incidents involving skin integrity. However, this was not fully robust and we identified that people with similar risks were not receiving the care outlined in their care plans to reduce risks associated with their skin.

The providers monitoring system were inadequate because failures identified at the inspection were not all known or acted upon.

People were not supported to have maximum choice and control of their lives and staff did not support

them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Systems were in place to monitor people's health, care and support needs, however, recent incidents had highlighted these were not always effective at ensuring concerns with people's health were identified in a timely way.

Care plans that were in place lacked person-centred detail. People's care needs were not always effectively reviewed to ensure care plans remained relevant and reflected their needs.

Some people told us they felt confident if they complained, they would be taken seriously. However, some people described communication difficulties with office staff.

Staff were recruited safely and deployed in sufficient numbers to meet people's needs. People and relatives we spoke with told us staff generally arrived on time, stayed the length of time they should and completed all care tasks. Spot checks were regularly carried out to ensure staff followed good infection control practices when completing care calls.

People told us they were supported effectively with food and drink and staff knew their likes and dislikes. People and relatives provided positive feedback about the skills and experience of staff. People were generally treated with kindness. There was some evidence people were involved in discussions about their care and their feedback about the quality of care was sought.

Staff mostly felt well supported and were guided in their role through induction, shadowing, training and supervision and appraisals.