12 July 2023
During an inspection looking at part of the service
People’s experience of using this service and what we found
Risks to people had not always been fully assessed or strategies recorded to reduce the risk of harm. Staff did not always have sufficient information or the skills and knowledge to support people safely. Training records did not evidence staff had received adequate training on people’s specific needs.
When people sustained an injury, records were not always clear on how the injury occurred, the size, shape or colour of injury or when the injury had healed. Investigations for incidents or accidents were not consistently in place.
People did not always know which staff were supporting them for each visit, staff did not always turn up on time or stay the allocated amount of time. However, people stated staff were kind and caring. Staff recruitment required improvement to ensure all necessary checks had been completed before staff worked with people. Policies and procedures were in place but had not been consistently followed.
Medicine management required improvement. Although we found no risk of harm, records were not consistently completed to ensure medicines were given as prescribed.
Systems and processes to ensure good oversight of the service, to identify concerns and make improvements were not effective or embedded into practice. Issues found on inspection had not been identified previously by the provider's own audits or reviews.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.
Staff felt supported by the manager. However, regular meetings were not held to discuss concerns, make suggestions or share information. Not all staff had received a spot check to check if staff were working in a safe, person-centred way or if they were following policies and procedures.
Relatives were kept up to date on any changes in people's need, incidents or accident that occurred. Staff supported people to access healthcare support if needed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 8 June 2022)
Why we inspected
We received concerns in relation to management oversight and staffing. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kare Plus Oxford on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to risk management and oversight at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.