The Care Quality Commission (CQC) has again rated Santos Care Limited inadequate and kept it in special measures to protect people following an inspection in April. CQC are also taking further regulatory action which will be published when legally able to do so.
Santos Care Limited, in Wolverhampton, is a domiciliary care service that provides personal care in people’s homes.
This inspection was carried out following concerns received about people’s safety, as well as to check on the progress of improvements CQC told them to make following the previous inspection last October.
At this recent inspection, there continued to be breaches around person centred care, consent, safe care and treatment and governance.
As well as the service being re-rated inadequate overall, so have the ratings for being safe and well-led. Effective, caring and responsive were not included in this inspection, therefore, effective remains rated inadequate and caring and responsive remain rated as requires improvement.
The service remains in special measures, which means it will be kept under close review by CQC to keep people safe and it will be monitored to check sufficient improvements have been made.
Andy Brand, CQC deputy director of operations in the midlands, said:
“When we inspected Santos Care Limited, we were deeply concerned to find significant improvements hadn’t been made since the previous inspection last October. The provider still wasn’t effectively monitoring the quality of care being delivered in order to drive necessary improvements across the service, so people were receiving safe care.
“Additionally, the registered manager had hardly been at the service since the last inspection, so they didn’t have any oversight of what was happening to be able to ensure people were receiving the personalised care they need and deserve.
“During the inspection, there was a lack of openness from staff, and information they provided was inconsistent, so it wasn’t clear how many people were receiving care and if their needs were being appropriately met to keep them safe.
“We found staff didn’t always record how they were supporting people, such as help with repositioning and nutrition. This put people at risk of receiving inconsistent care.
“Also, people’s capacity to make specific decisions hadn’t always been assessed and it wasn’t clear if restrictions, such as the use of bed rails, had been made in people’s best interests. Where people did have bed rails in place, care plans said relatives had consented, but there wasn’t a record of these conversations, which could put people at risk of being restricted unlawfully.
“We’ve told leaders at Santos Care Limited where they need to make urgent improvements, and we'll be monitoring this service closely to ensure people are kept safe. We’ve also taken further enforcement action and will report on this when we’re legally able to do so.”
Inspectors found:
- The provider still didn’t ensure risks to people were properly assessed which meant staff did not have access to guidance to support people safely
- There were still no systems in place to make sure medication was administered safely
- There continued to be a lack of effective management which meant people’s care was not effectively monitored, placing them at risk of potential harm
- Audits did not always accurately reflect the care being provided to people
- Safeguarding referrals had to be made to the local authority for people whose support had ended with an unconfirmed notice period to ensure they were safe.
However:
- There were enough staff to support people and any late calls were notified in advance.