Archived: Gentle Hearts Care Limited

The service provided domiciliary care to 90 people in their own homes. There was a registered manager at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

Staff we spoke with were knowledgeable about how to meet the care needs of the people they supported although records did not identify all the training staff had undertaken or when further training would be required. Recruitment processes ensured people were supported by staff who were suitable to meet their care needs.

The registered manager was aware of their legal responsibilities to notify the commission of specific events however they had not ensured their latest ratings were clearly displayed on their website. They had not established adequate quality monitor processes to identify if the service was meeting people’s needs or how it could be improved. They did not always respond to concerns raised by other agencies. Audits had not always identified when errors in record keeping had occurred. Information was not reviewed for trends and to identify learning opportunities. You can see what action we have asked the provider to take at the back of the report.

Medicines were not managed safely. Medication records did not clearly indicate what medication people should be supported to take or when. Staff who were to support people to take their medication had not always indicated they had done so. You can see what action we have asked the provider to take at the back of the report.

Staff we spoke with knew how to recognise the signs of abuse. Care plans identified people’s specific conditions and how staff were to support them to keep them well. When necessary the provider involved and worked with other professionals to meet people’s care needs.

The registered manager sought people’s views of the service. Senior staff conducted spot checks and observations of how staff supported people. We saw the providers response to complaints was not consistent or in line with good practice. You can see what action we have asked the provider to take at the back of the report.

People were generally supported by the same staff which had helped them to develop positive relationships. Staff knew how people liked to be supported and told us how important it was for them to meet people’s needs. People told us they were supported when necessary by staff to eat and drink enough to keep them well.

People we supported to decide how they wanted their care to be delivered. Senior staff would take part in best interest meetings when people were thought to lack mental capacity.

We gave the manager short notice of our inspection. On the day of our inspection there were 117 people who used the service. We talked with the manager and looked in detail at the care records for six people. We spoke on the telephone to six people who used the service and three relatives. We spoke with three members of staff.

Below is a summary of what we found. The summary describes the records we looked at and what people using the service and staff told us.

If you want to see the evidence that supports our summary, please read the full report.

Is the service safe?

We spoke with six people who used the service. They all liked their carers. Care staff understood their role in safeguarding the people they supported. We found that not all risk assessments had been completed to protect people and keep them safe from harm. Safeguarding alerts had not been raised in some cases when they had been needed. The knowledge of correct safeguarding procedures at management level was not robust.

Is the service effective?

We saw that people who received care and support from the agency had a care plan. Most of the records we looked at had been reviewed on a regular basis, or earlier if required. This meant that people could feel confident that the service could meet their individual and personal care needs.

We viewed records which showed us training and development was provided to staff to enable them to deliver support safely and to an appropriate standard. We spoke with six people who used the service who told us staff were knowledgeable about their individual care needs and they were confident in staff abilities when support was being given.

Some people we spoke with reported that their carers were often late. One relative said, 'Sometimes they can be up to two hours late. I would really like them to phone X and let her know if they are going to be late.' One person told us, 'The girls are rushed, there's not a lot of time.'

Is the service caring?

All the people we spoke with were happy with the care and support provided by the agency. People told us that the service engaged with them to ensure that their needs and wishes were met. Relatives told us staff were caring and kind. One person told us, 'They are fine, they are always smiling and do the job properly.' Staff told us they were clear about their roles and responsibilities to respect people's privacy and dignity. One person told us, 'I find them fine. On the whole they are pretty good.'

Is the service responsive?

People told us that they could contact the office if they needed to. One person said, 'The office is OK.' A relative said, 'We had a problem with one carer and it was sorted.' People we spoke with felt that they could contact the office when they needed to. Most people confirmed that they were happy with the care they received.

Is the service well led?

Staff felt supported and records we reviewed confirmed that staff were appropriately trained. We saw the service did not have systems in place to ensure people were regularly consulted about their views and ideas on how the service should be run. There was no process in place to check that parts of the service were being delivered well. The recording of complaints and how to follow the correct procedures was lacking. Complaints had not been followed up and there was no system for the manager to know when a complaint had been resolved or if it needed further action.

People or their relatives told us they were happy with the support the staff provided and that it met their needs. One relative told us, 'They are very good'. However, several people also told us that they were not always supported by staff they knew.

We saw that the provider had made suitable arrangements to ensure that people who used the service were safeguarded against the risk of abuse.

The provider had robust recruitment procedures in place to ensure that people employed at the service were of good character and had the necessary skills, qualifications and knowledge to meet the needs of the people who used the service.

The provider had several systems to capture the views of staff and people who used the service although information was not always analysed and acted upon.

The provider had a system in place to deal with comments and complaints. People told us that they knew how to raise a complaint and felt that they would be listened to.

People were involved in their care and were encouraged to do things for themselves if possible. One person said, 'They help me to choose what I want to wear each morning. They are kindness itself.'All staff spoken with knew what people's support needs were and when to visit, because care plans were detailed and contained risk assessments, which stated what peoples support needs were and how people chose to be cared for.

All staff knew how to protect people so that they were always safeguarded from harm. One person said," Staff make sure my door is locked when they leave I feel safe and secure.'' The provider has a robust system in place to monitor care calls. So that peoples care and welfare was protected.

All staff were supported and trained in their roles to give them the skills and knowledge to know how to meet people's needs and ensure their well being.

There were robust audit systems in place to monitor how the service was run. The provider has an effective complaints system and people had been encouraged to raise concerns so that that areas for development were identified and actioned.

People who receive care and their relatives were asked for their views about the service and these were listened to.