Archived: Goodhands Commcare Ltd

Goodhands Commcare Ltd is a domiciliary care agency registered to providing personal care. At the time of the inspection three people were receiving care.

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

Medicines were not managed in a safe way. There continued to be no risk assessments about people’s health conditions or concerns even though we specifically wrote about this in our previous inspection report. This meant people were not kept safe as staff did not know about risks to them. There had been one incident since our previous inspection, but it had not been recorded appropriately. Not all staff had completed safeguarding training. Staff recruitment application forms lacked information such as their employment histories. There was little documentation in relation to Covid-19. What there was, was inadequate and the provider was unable to evidence learning around pandemic specific infection control with neither updated risk assessments for people or staff.

Oversight of staff training had been neglected and records were out of date, though these were updated during the inspection. Staff had not completed training the provider deemed mandatory. Staff were relatively new and there was no record of their having been supervised or properly inducted into the service. Daily notes were completed when staff cared for people, however, we found one instance when this had not occurred.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The provider had completed consent agreements with people but there was a lack of information in people’s care plans about their ability to make choices for themselves. People’s preferences around food and drink were recorded and people were supported by staff to eat, though not all staff had received training in this area which the provider had deemed mandatory.

There were numerous shortfalls in the service the provider had failed to address. Care plans were not up to date and had not been reviewed for six months prior to our inspection. They were updated during the inspection. Quality assurance processes, including audits, surveys and spot checks, were not completed regularly. The provider had told us at our previous inspection they would employ a registered manager and had failed to do so. Meetings had ceased to occur frequently and actions arising from them were not recorded properly with no staff being held responsible for them. The provider had failed to draw up a contingency management plan after being specifically requested to do so and had failed to register their service location correctly. The service had drawn up a service level agreement with another provider so as to evidence their working with others but had not joined any forums or organisations to support innovation at the service and had not recorded details of some health care professionals who supported people using the service.

Relatives told us staff were caring and thoughtful when supporting people. Following our inspection, the provider decided to voluntarily cancel their registration as a health and social care provider and subsequently supported people to transfer their care to other providers.

Rating at last inspection and update

The last rating was inadequate (published 01 April 2020) and there were multiple breaches of regulation. The provider failed to complete actions set out in an action plan that we requested after the last inspection to show what they would do and by when to improve. At this inspection we found only minor improvements had been made and the service remained inadequate.

This service had been in Special Measures since 01 April 2020 and remained so until their registration was cancelled on 19 November 2020.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

Please see the action we have told the provider to take at the end of this report. We will not be pursuing regulatory action as the provider has cancelled their registration.

Follow up

The overall rating for this service is ‘Inadequate.’’ As the service is no longer registered to provide a regulated activity we are not pursuing further enforcement action.

Goodhands Commcare Ltd is a domiciliary care agency registered to providing personal care. At the time of the inspection six people were receiving care.

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

Medicines were not managed safely. Medicine administration records were unclear and incorrectly completed. There were no audits of medicine administration records, so the provider was unaware of these records being completed incorrectly. Care plans lacked people’s medicine needs and risk assessments. There were no risk assessments about people’s health conditions or concerns. This meant people were not kept safe as staff did not know about risks to them. Incidents and accidents were recorded but the provider did not inform the local authority to safeguard people involved. There were gaps in staff employment histories.

There was no oversight of staff training and the management team were unable to tell us what training staff had completed. We saw one staff member had only completed one mandatory training. Staff were not receiving supervision, which we had made a recommendation about at our previous inspection.

Care plans were not up to date. We previously made a recommendation about following best practice around care planning due to a lack of clarity around people’s involvement with care reviews. The provider had not acted on this and we saw care plan reviews were not being held regularly and when they were, it was unclear people and or their relatives were involved as there were no signatures to indicate their consent.

Quality assurance measures were inadequate. Spot checks and reviews were not being completed regularly. There were no medicine administration record audits. There were no surveys being completed. The provider had not completed an action plan they were supposed to following the previous inspection. The provider had not notified us about the departure of the registered manager. Meetings were infrequent and were not recorded properly. The service needed to improve their ability to work with other professionals. They did not attend forums or conferences and were not part of any local forums that might assist to improve their service offer to the people they worked with.

There were sufficient staff working at the service. Staff told us they knew how to report abuse. Staff understood the importance of infection control.

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. People’s needs were assessed before they began using the service. People were supported to eat and drink. People were supported with healthcare where necessary. Staff communicated with other agencies on behalf of people where necessary.

People and their relatives told us staff were caring. The providers documentation supported equality and human rights. People’s privacy and dignity was respected, and their independence promoted.

People’s communication needs were recorded, and people were supported to receive communication in a way they wanted. There had been no complaints since the previous inspection and people and relatives told us they knew how to complain.

Rating at last inspection (and update)

The last rating was requires improvement (published 02 February 2019) and there were multiple breaches of regulation. The provider failed to complete an action plan that we requested after the last inspection to show what they would do and by when to improve. At this inspection we found no improvements had been made and the service had deteriorated.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified continued breaches in relation to safe care and treatment, protecting people from abuse, fit and proper persons employed, staff training and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Please see the action we have told the provider to take at the end of this report.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

People’s experience of using this service:

People told us they were happy with the care provided by Goodhands Commcare ltd. One person told us “I’m very satisfied with everything” while a relative told us, “I’ve had worse. They are excellent – they do know what they are doing.” However, we had numerous concerns about how the service was managed, in particular we found evidence that indicated the service was not well-led.

No staff had completed any infection control training though staff we spoke to did have an understanding of infection control. We discovered one person whose health needs would require staff to have good knowledge of infection control and we asked that care to this person cease until staff had been trained. Lessons were not always learned when things went wrong as we found incidents were not recorded properly. Risks to people were not always recorded or identified. Recruitment practices were poor. Medicines were not always recorded and managed properly. There were safeguarding processes in place and staff appeared to have an understanding of what to do if they suspected abuse, but no staff had received any training on safeguarding.

There was no recognised mandatory training within the service and the attendance of training courses was poor. Staff had not received any supervision that had been documented. They were no inductions recorded in staff files. We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA), legislation that protects people with mental capacity and memory issues, and found them to be non-compliant as staff did not understand the principles and no staff had received training on the MCA.

There were sufficient staff working at the service. People’s needs were assessed before they received a service. People were supported to eat and drink. Staff communicated effectively with each other about people’s needs. People were supported to lead healthier lives.

People told us that staff were caring. People were supported to express their views and were involved in decision making about their care, however we have made a recommendation about care planning. People’s privacy was respected and their independence promoted.

People’s needs were recorded in care plans and they received care from staff who knew them. However, we have made a recommendation about capturing people’s preferences. People knew how make complaints but told us they had no need to.

The registered manager was unaware of the needs of the service. Staff were aware of their roles. Quality assurance measures at the service were poor as they did not complete a broad range of audits and checks on safety and quality. There were no meetings held but the service told us they would hold staff meetings. The service had yet to form partnerships with others.

Rating at last inspection: This is the services first inspection.

Why we inspected: This was a planned inspection based on our scheduling of regulated services.

Follow up: We identified breaches of two regulations relating to safe care and treatment and staffing. You can see what action we told the provider to take at the back of the full version of the report. We have also made two recommendations in this report that will be followed up at our next inspection. We will continue to monitor intelligence we receive about this service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.