Local Homecare

During the assessment, two regulatory breaches were identified relating to safe care and treatment and good governance.

The assessment and planning of care did not consistently follow best practice guidance. Several people had specific risks associated with skin integrity, PEG feeding (Percutaneous Endoscopic Gastrostomy), mobility and moving and handling, catheter care, and stoma care. However, these risks had not been adequately assessed. As a result, staff lacked the necessary information to mitigate these risks effectively and deliver safe care.

Medicines management was unsafe. The provider did not adhere to best practice guidance issued by the Royal Pharmaceutical Society, the Care Quality Commission (CQC), and the National Institute for Health and Care Excellence (NICE). Medicines records were poorly maintained, with evident gaps in administration documentation. Although audits were in place, they failed to identify these discrepancies, indicating a lack of robust oversight.

Staff recruitment processes were safe and ensured that people employed were suitable to work with vulnerable people. While staff had prior experience in care settings, they had not received appropriate training in key areas such as stoma care, catheter care, PEG feeding, or implantable cardioverter-defibrillator management. This lack of training meant the provider could not be confident in the staff’s competencies to deliver safe and effective care in these areas.

Governance within the service required improvement. There was an absence of effective quality and safety checks, and policies relating to service delivery were not consistently followed. This resulted in significant shortfalls in care assessment, planning, delivery, medicines management, staff training, and leadership. These issues had not been identified or addressed, which meant the provider was not meeting their regulatory responsibilities. These concerns were discussed with the registered manager, who was receptive to the feedback and expressed a commitment to improving the service.

Despite the identified concerns, the culture of the service was open and transparent. It was evident that the provider, registered manager, and staff genuinely cared for the people they supported. Both people and their relatives were starting to become actively involved in planning and making decisions about their care and this was evidenced by communication channels that were being opened.

We have asked the provider for an action plan in response to the concerns found at this assessment.