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People’s experience of using this service and what we found

Risks to people and staff including those presented by the COVID-19 pandemic were not always assessed and recorded and staff were not always being tested for COVID-19 in accordance with government guidelines.

Medicines records and governance arrangements did not always assure that medicines were managed safely.

The provider's quality systems were not sufficiently robust to identify the concerns we highlighted with lack of effective risk assessment and the management of medicines.

The provider was very responsive in taking actions to address the issues we found on inspection however we could not fully assess the impact of these actions until they were fully embedded.

People told us that they felt safe whilst receiving care and all, without exception, were complimentary about the standard of care and services they had received.

People received consistent care from well trained staff who knew them well and they were familiar with. One person told us, “it is an excellent service, I feel so lucky to have them” and another said, “they are very pleasant always treat me with respect, very cheery and happy to have a chat”.

Staff rotas were developed using an electronic call monitoring system. This ensured people received care as and when they needed it and reduced the risk of ‘missed calls’ occurring.

Staff had received training on a range of subjects including COVID-19. They had access to appropriate personal protective equipment (PPE) in accordance with government guidelines.

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 supported this practice.

Staff clearly understood the importance of supporting people to develop and maintain relationships and where appropriate involved families, and other advocates in care and support planning processes.

People received care that reflected their needs, characteristics, and personal preferences. Health and social care professionals spoke highly of the standard of care provided. They gave examples as to how managers and staff had worked collaboratively to develop person centred care with positive outcomes for the people who used the service.

The service had a complaints policy and procedure and we saw complaints were dealt with in line with the policy. We also saw the service had received many compliments about the quality of care provided.

The management team were open and transparent throughout the inspection and responded to any requests positively.

People who used the service, their relatives, and staff told us that all members of the management team were approachable, supportive, and always responded effectively to solve problems and improve the service.

We have made recommendations about best practice guidance for oral care and checking staff recruitment files for completeness.

Why we inspected

This service was registered with us on 23 August 2019 and this is the first inspection. The overall rating for the service has been assessed as requires improvement. This is based on the findings at this inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We have identified breaches of regulations in relation to safe care and treatment and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Prompt action was taken by the registered manager after the inspection to mitigate risk and improve the quality of care in response to the concerns we found during our inspection.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection program. If we receive any concerning information we may inspect sooner.