The inspection revealed that "robust safeguarding systems were not in place" and that staff had "not completed key training" necessary for effective care.
A CQC spokesperson noted they were looking into the very sad death of someone using the homecare service to decide on potential regulatory actions.
Concerns were raised about the management of choking risks, highlighting that the service requires improvement in their systems for monitoring and risk management.
The service's inspection report emphasized that proactive measures to minimize choking risks were absent, showcasing critical gaps in safety protocols.
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