Jewel Home Care

This inspection was completed to check compliance with previous breaches of legal regulation.

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed autistic people and people with a learning disability respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

The provider was in breach of the legal regulation relating to safe care and treatment and good governance.

There was a lack of reliable, person-centred guidance in several high risk areas, which meant support was not consistently safe or well-coordinated. In particular, risks linked to complex conditions such as epilepsy, Parkinson’s disease, diabetes, oxygen dependency and pressure area care were not consistently identified, recorded or managed through clear instructions that staff could follow.

Records did not demonstrate people were consistently receiving safe, effective care that met their needs. Records contained gaps, inconsistencies and conflicting guidance, including examples where documentation directed staff to take actions that did not align with prescribed medicines. We were not assured that staff had the right information to recognise deterioration early, respond appropriately, and escalate concerns in a timely way.

The service did not demonstrate a culture that consistently supported safe care, effective oversight and continuous improvement. This was a follow up inspection intended to confirm the provider was now operating within legal requirements, but significant concerns remained and some areas the provider said had been resolved and improved were still inadequate when we returned. Governance and quality assurance systems did not provide reliable oversight and did not identify or correct risks before inspection, which contributed to people remaining at significant risk of harm. While staff records showed supervisions and appraisals were taking place and a whistleblowing policy was available, the whistleblowing guidance did not clearly explain what staff should do if their concern related to their line manager, which reduced assurance that staff could raise concerns safely and independently.

This service remains in special measures. The provider did not demonstrate that adequate improvements had been made. Therefore, the service remains rated as inadequate overall and remains in Special Measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a time-frame within which providers must improve the quality of the care they provide.