1st Central Care Ltd

Overall, the quality of care provided was inconsistent, and there were significant concerns across all key questions. While people and relatives highlighted positive experiences with some individual staff members, these were not consistently supported by effective systems, governance or leadership to ensure safe, person‑centred and high‑quality care.

People were at risk of avoidable harm due to widespread failures in safety systems. There were serious concerns relating to medicines management, infection prevention and control, incident management and staff training. Medicines were not always administered safely, records were incomplete, and audits were largely absent. Infection control practices were inconsistent, with people and relatives describing poor hand hygiene and glove use. Incidents and safeguarding concerns were not always investigated, reviewed or reported appropriately, limiting opportunities to learn and improve safety.

The effectiveness of care was variable. While some people experienced good outcomes, particularly where staff worked closely with hospice and healthcare professionals, care planning and risk management were not consistently robust or up to date. Delays in reviewing care plans and call times that did not align with people’s needs affected people’s comfort, pain management and wellbeing. People and families were not always involved in reviews, and outcomes were not routinely monitored to ensure care remained effective as needs changed.

Caring practice was mixed. Many people spoke positively about the kindness, compassion and reassurance provided by individual carers, and examples were seen where people’s preferences and dignity were respected. However, these positive experiences were undermined by inconsistent staffing, gaps in training and poor care planning, which meant people did not always feel well supported or confident in the care being delivered.

The service was not consistently responsive to people’s needs. People often did not know who would be attending or when, and late or shortened visits affected people’s independence, choice and control. Care records lacked sufficient detail to guide staff in responding to people’s individual needs, increasing the risk of inconsistent care.

Leadership and governance were significant areas of concern. Systems to monitor quality, safety and performance were ineffective or absent. The provider did not have adequate oversight of risks, safeguarding, medicines, staffing or data protection. Although the management team were described as approachable and supportive, these qualities were not supported by the knowledge, systems or governance required to run a regulated service safely.

In summary, despite pockets of good practice and positive feedback about individual staff, widespread and significant improvements are required to ensure people receive safe, effective, caring and well‑led care.We found 5 breaches of regulations during our inspection activity, these breaches related to safe care, recruitment practices, staff development, person centred care and good governance.

In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded.We have asked the provider for an action plan in response to the concerns found at this inspection.