A Newton Poppleford-based home care service that was judged 'inadequate' by the Care Quality Commission (CQC) last October has been re-inspected – and found to be still in need of improvement in some areas.

Charity Earnshaw supports adults with dementia, physical disabilities, mental health needs and sensory impairments.

In October, the inspectors' concerns included a lack of staff training in infection control, including the specific training needed in response to Covid-19, and poor risk management.

They found that the administration of medicines was 'not safe', again because staff had not always had the necessary training, and medication errors had not always been identified or reported.

The service was placed in 'special measures' and told to tackle the issues highlighted. A follow-up inspection took place in April, and the report has just been published.

It rated the service 'good' for being caring and responsive, but said it 'requires improvement' in safety and effectiveness, and was 'inadequate' in leadership.

What the April inspection found

The summary of the latest report says: "At our previous inspection in October 2020 we found risk assessments did not consistently provide the information staff needed to understand and minimise risks. This was still the case. Risks associated with people's care had now been assessed but the assessments were not always accurate and did not consistently provide the guidance staff needed to support people safely.

"When we last inspected, we found safeguarding concerns had not always been managed appropriately and had not been reported to the local authority or the Care Quality Commission. Safeguarding policies and procedures were out of date.

"At this inspection we found improvements had been made but further improvements were still needed. Although the provider had been proactive in raising safeguarding concerns, this was not consistent. Safeguarding policies and processes had been reviewed but did not always provide staff with the information they needed to raise a concern.

"Some people and staff spoke highly of the provider and the way the service was managed. Others found the provider's management style challenging. The provider was aware of this and told us, "I am very approachable with our staff and service users. I have gone above and beyond to try to make them happy… I do know my direct way of speaking is not always taken well and I try to moderate this, but this is my nature."

The improvements that have been made

However, the inspectors noted that some important changes had been made. They said: "At our previous inspection in October 2020 we found the administration of medicines was not safe. This was no longer the case. Staff now had the necessary training and their competency checked. The provider regularly reminded staff about safe medicines administration. Robust quality assurance checks were in place."

The summary also notes that "Emergency plans had been developed to manage issues potentially affecting service provision, such as adverse weather conditions or staff sickness.

"We found people were now 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. This had not been the case at the previous inspection in October 2020."

The overall rating of 'requires improvement' means Charity Earnshaw will remain in special measures. The service will be kept under review by the CQC and will be re-inspected later this year.