Afresh Healthcare Limited

Enough staff were employed to provide the care people needed but the registered manager was unable to demonstrate staff had been recruited safely.

People's medicines were not always managed safely. People told us that when they needed support with their medicines staff were there to support them. However, medicines administration records (MARs) which were written by the service did not have sufficient information on them to ensure the possible risk of administration was mitigated. For 'when required' medicines, also known as PRN medicines, these were not listed on the MAR chart or in the care plan and clear directions for staff on how PRN medicines should be taken or given was not evident.

People were asked to give their consent for support and the principles of the Mental Capacity Act were followed. People were supported to have a maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, staff had variable knowledge about the MCA.

People were at risk of poor care and support because the registered manager did not have effective auditing and governance systems in place to monitor the quality of the service. Audits had not been robust to identify the concerns and shortfalls we found on the inspection. Opportunities to learn lessons could have been missed.

People felt safe with the care and support provided by the service. All staff had received safeguarding training and knew how to protect people from potential harm.

The services infection prevention and control policies and procedures were being adhered to, ensuring both staff and people using the service were protected from cross contamination.

People's needs were assessed prior to using the service. People felt listened to, respected, and involved in decisions about their care and support. Each person had a personalised care plan in place which detailed their care needs and preferences and gave staff guidance on how to provide safe and effective care. These

were reviewed regularly.

Staff had completed all mandatory training and some staff were being supported by the registered manager to achieve further accredited training. Observational checks of staff practice were taking place.

Staff treated people with respect and upheld their privacy and dignity. People described staff as very polite, respectful, kind, and caring. Staff knew people well and encouraged them to be as independent as possible.

People and staff were positive about the registered manager. Staff said the registered manager was approachable, welcomed ideas, and always responded.