M N Pulse Solutions

⚠ We reviewed two staff employment records and whilst both had a DBS (Disclosure and Barring Services) and identity checks had been completed, we found gaps in other important information. One staff file had gaps in employment and education history, and these gaps had not been explored by the registered manager …

⚠ References had not been sought for one staff member from their most recent employer or place of education.

⚠ Staff did not currently have information available to them about a person's medication to refer to in the event of an emergency.

⚠ Whilst actions had been taken to minimise reoccurrence, improvement was needed to the records maintained such as to include dates and full detail about the incident and investigation.

⚠ Care records detailed when a person could make day to day decisions about their care and support. However, more detailed information was needed where a person's capacity may vary and posed a potential risk to themselves or others through their actions.

⚠ For example, checks on staff employment records had not identified the short falls we found in robust staff recruitment.

⚠ For example, one care plan reviewed had contradictory information which in one section stated a person was at low risk of dehydration and in another section recorded they were at moderate risk of dehydration because they may not be able to access drinks for themselves. Staff always left a drink …

⚠ Whilst spot checks had taken place, these had not always assessed staff's skills and competencies to ensure learning had taken place from the training given.