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Inspection Summary


Overall summary & rating

Good

Updated 26 April 2018

This inspection took place on 27 and 30 November 2017. This was an announced inspection as Gardiner’s is a Domiciliary Care Agency (DCA) and we needed to be sure someone would be at the office. A DCA is a provision that offers specific hours of care and support to a person in their own home.

At the time of the inspection a registered manager was in post. 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 2008 and associated Regulations about how the service is run.

The service was rated at the previous inspection of September 2015 as safe and remained safe. Sufficient staff were employed to manage people’s needs, and enable them to engage in activities of their choice, through appropriate risk management. Staff knew how to safeguard people from abuse and were aware of the protocols to follow should they have concerns. Staff reported that they would not hesitate to whistle-blow if the need arose. Where staff were involved in medicine management this was managed safely. Staff were competency checked annually and audits were completed monthly to ensure people were supported by staff with the necessary skills to keep them safe.

The service remained effective. Support was delivered by a highly trained staff team, who were able to respond appropriately to people’s changing needs. Staff were supervised and supported by an effective management team, who made certain they were available to staff at all times. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

The service remained caring. Staff were reported to be polite, respectful and ensured they maintained people’s dignity when supporting them. They encouraged open communication and worked on motivating people to increase their independence. Evidence of using systems of communication that reflected the person’s choice highlighted that staff communicated with people in the way they wished.

The service remained responsive. Care plans were individualised, focusing on people’s specific needs. The service took necessary action to prevent and minimise the potential of social isolation. Activities were arranged and co-ordinated by the service to increase community engagement, and increase well-being. People reported having accessed the community after considerable length of time of not doing so. This reportedly made them feel a sense of belonging. People and staff were protected from discrimination. The service understood the importance of ensuring Equality Diversity and Human Rights (EDHR) was met, and that people’s protected characteristics were not discriminated against. Measures were in place to allow people to be treated equally, with systems continually being reviewed to ensure exemplary practice was maintained. Systems to monitor and investigate complaints were in place.

The service had developed exceptional methods of good governance that provided real time evaluation of practice. A thorough quality assurance audit was completed annually with an action plan being generated, and followed upon. Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service. We found evidence of compliments and complaints that illustrated transparency in management. Staff spoke highly of the registered manager’s skills and how these were shared with staff to continually help them grow and achieve good practice. The service focused on developing relationships with the community and with relatives of people, so to ensure good practice was maintained for the person continually. The service was considering offering family carers the opportunity to attend training that would enable them to have an insight into their loved one’s lives and how t

Inspection areas

Safe

Good

Updated 26 April 2018

The service remains good.

Robust recruitment procedures remained in place.

Staff knew how to safeguard people from abuse, and how to report any concerns.

Assessments to mitigate risk were in place and used appropriately.

Effective

Good

Updated 26 April 2018

The service remains good.

People were involved in making decisions related to their care.

Staff had the necessary skills and training to effectively carry out their duties.

Staff received regular supervision, appraisals and observational checks to ensure effective support was provided to people.

Where applicable people were supported with nutrition and hydration.

Caring

Good

Updated 26 April 2018

The service remains good.

Staff were respectful, compassionate and caring towards people.

People�s privacy and dignity was maintained.

People�s method of communication was respected and as far as possible used.

People were paired based on knowledge, experience and background with staff who worked with them.

Responsive

Outstanding

Updated 26 April 2018

The service remains Outstanding.

Systems to manage complaints were in place. People were encouraged to use advocates or family members to raise issues.

Care plans were individualised and reflective of people�s changing needs.

Measures were in place to help reduce social isolation and encourage community engagement.

People were protected from discrimination.

The service ensured that information was presented to be people in a format that was accessible to them.

Well-led

Good

Updated 26 April 2018

The service remains good.

The management team continually focused on progressive methods of improving the service.

Governance of the service was consistent, and outcome focused.

The service successfully focused on developing community links and reducing people�s isolation in an innovative manner.

The service ensured that they worked in partnership with families, offering them the opportunity to access training provided to staff.

The service ensured they took the appropriate steps to equally treat people and staff.

The service was well-led with a transparent management team described as being approachable and continually available.