Competent Healthcare Ltd

During this assessment we looked at 4 quality statements in the key question of safe. The overall rating for this key question combines scoring from quality statements we looked at during this assessment and quality statements scores in line with findings from our last inspection, where the service was rated good. There were not effective systems in place to manage risks related to people’s health, medicines and delivery of care. This included risks around time critical medicines, medicines administration guidance, business continuity, choking risk assessments and environmental risk assessments. These failings put people at increased risk of coming to harm. This was a breach of Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Staff had a good knowledge of safeguarding, but concerns were not always fully followed up and actions were not always recorded to demonstrate how people were kept safe. There were enough staff in place to meet people’s needs. However, staff did not always arrive at planned times, specifically when care calls required 2 staff. Staff told us they had received appropriate training relevant to their role, but records of staff training were not available, therefore we could not verify or be fully assured in this area.

During this assessment we looked at 1 quality statement in the key question of effective. The overall rating for this key question combines scoring from quality statements we looked at during this assessment and quality statements scores in line with findings from our last inspection, where the service was rated good. The provider did not always obtain valid consent to people’s care. Their processes were not always in line with The Mental Capacity Act 2005. This was a breach of Regulation 11 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

During this assessment we looked at 1 quality statement in the key question of caring. The overall rating for this key question combines scoring from quality statements we looked at during this assessment and quality statements scores in line with findings from our last inspection, where the service was rated good. Staff had a good knowledge of people’s needs, abilities and preferences. People told us they were happy with the care they received and had developed good working relationships with staff. However, people told us they were not always involved in developing and reviewing their care plans. Care plans did not always reflect the care they received or the level of support they required in specific areas. Some care plans lacked details about people’s background, preferred routines and how they should be supported to maintain their independence.

During this assessment we looked at 3 quality statement in the key question of well led. The overall rating for this key question combines scoring from quality statements we looked at during this assessment and quality statements scores in line with findings from our last inspection, where the service was rated good. The provider did not have effective governance systems in place to monitor and improve the quality of care and safety of the service. The provider had not always reported significant incidents to local safeguarding teams or CQC as required. This was a breach of Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.