Chadcome Healthcare Limited

People’s medicines were not managed safely; medicine records were incomplete and did not contain information in accordance with national guidelines. Systems for managing risk were not always effective, care plans lacked detail to mitigate risks and provide staff with guidance on how to respond to an emergency. People were protected from the risk of abuse; staff understood their safeguarding responsibilities and knew how to contact relevant local authorities if they had concerns. Infection prevention and control measures were consistently followed. People’s home environments were assessed to reduce risks to them and promote staff’s safety. There were enough staff who were trained to meet people’s needs, however, recruitment practices required review.

People were involved in initial assessments and had opportunities to share their views and wishes. Nationally recognised assessment tools were not routinely used to ascertain people’s health risks. Staff supported people with meal preparation and knew people’s preferences; however, recommendations were not always included in care records. People were consistently asked for consent and permission from staff, although formal consent forms were not completed.

People told us staff were kind and caring. Staff knew people very well and supported them to retain some independence whilst ensuring they had choices and control over their lives. Staff respected people’s dignity and people were complementary about the way they were treated by staff. Where people expressed preferences to who they would be supported by, this was met. Staff wellbeing and inclusivity was respected and staff told us they felt valued.

People’s care was responsive and person-centred as people were supported by a consistent staffing team. However, person-centred information had not been included in people’s care records such as individual communication needs and preferences. There was a system in place to address complaints and to learn lessons from the outcomes. Information was available to people in accessible formats to suit individual needs.

Leadership was inconsistent, the registered manager no longer held day to day oversight of the service. The provider had not updated CQC of the changes within management and had not returned statutory requests for information. The nominated individual was overseeing the service and shared plans for changes in management. Governance systems were not in place to monitor and review the service, people were asked for feedback in a casual basis, but no formal feedback had been requested. The provider shared plans of expansion and a wish to work collaboratively with professionals and engage with the local community.

The nominated individual responded to our feedback positively. They shared some improvements which had been made during the inspection and communicated their plans for ongoing improvements.

We have identified two breaches of Regulation in relation to safe care and treatment and governance at the service. We have asked the provider for an action plan in response to the concerns found at this inspection.