The Care Quality Commission
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Gain Healthcare Ltd

Overall: Inadequate read more about inspection ratings

5 London Road, Bicester, OX26 6BU (01869) 934787

Provided and run by:
Gain Healthcare Ltd

Important: This service was previously registered at a different address - see old profile

All Inspections

During an assessment under our new approach

Date of Assessment: 11 February 2026 to 13 March 2026. Gain Healthcare Ltd is a domiciliary care agency which provides personal care to people in their own homes. The service was also registered to provide supported living. The service was not providing this support to people receiving a regulated activity at the time of our inspection, therefore we did not assess it.

This was a responsive assessment prompted by concerns received about the safe care and treatment of people using the service. A decision was made for us to inspect and examine those risks.

CQC only inspect where people receive personal care. This is help with tasks relating to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our assessment, 1 person was receiving the regulated activity of personal care.

We assessed the service against the Right Support, Right Care, Right Culture guidance to determine whether the provider ensured that people with a learning disability and autistic people were treated with respect, equality, dignity, given choices, independence, and good access to local communities that most people take for granted.

We found these principles were not always upheld.

We found 7 breaches of the legal regulations in relation to person-centered care, safe care and treatment, safeguarding, need for consent, and staffing, and continued breaches of good governance and submitting notifications to CQC.

Documentation did not always contain correct, up to date information about the person and their specific support needs or risks. Assessments lacked sufficient detail, and guidance was not in place for staff to support the person’s safety. Staff did not have effective training in place to support the person and their needs. Medicines were being administered by staff without the appropriate information, guidance or training in place.

Governance arrangements were not effective, as existing audits failed to identify the concerns found during this assessment.

This service is being placed in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide.

In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.

We have asked the provider for an action plan in response to breaches of regulations relating to person centred care, consent and notifications of incidents to us to enable us to monitor progress within the service.

During an assessment under our new approach

Date of Inspection:22 January 2025 to 25 February 2025. The service is a domiciliary care and supported living service providing the regulated activity of personal care. This inspection was in response to CQC receiving information of concern.

The inspection was prompted in part by information of an incident following which a service user was at risk of financial abuse. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident.

Systems in place to report and investigate safeguarding concerns were not always effective. Concerns relating to abuse were not always reported.

Systems were in place to identify and manage risks to people. However, these systems were not always effective, and interventions did not always result in positive outcomes.

There was a range of checks and audits to monitor the quality and safety of the service and to help drive improvements. These included checks on risks to people, care plan reviews, spot checks and medicines. However, these systems were not always effective. Audits failed to identify our concerns relating to safeguarding, notifications and risks to people’s care and support. The provider did not always notify CQC of reportable events. A notification is information about important events which the provider is required to send us by law . These are breaches of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 17 Good governance and the Care Quality Commission (Registration) Regulations 2009: Regulation 18

Medicines were managed well, and people received their medicine as prescribed. Staff were suitably employed and trained and had access to further training when required. Staff spoke positively about the management at the service and told us they felt supported.

24 March 2023

During an inspection looking at part of the service

About the service

Gain Healthcare Ltd is a domiciliary care and supported living service providing the regulated activity of personal care. At the time of our inspection there were 2 people receiving the regulated activity of personal care.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

We have made a recommendation about the systems and processes used to ensure the service are not depriving people of their liberties without the correct authorisation from the Court of Protection.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Safe recruitment practices had taken place to gather satisfactory evidence of staff conduct in all relevant previous employment. The model of care and setting maximised people’s choice, control and independence. People who experienced periods of distress had proactive plans in place which ensured restrictive practices were only used by staff if there was no alternative.

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. However, people had been deprived of their liberty without the appropriate legal authorisations being sought from the Court of Protection. Whilst this was not the immediate responsibility of the provider, they had not through their own systems, identified or taken action in response to this shortfall. We raised this with the registered manager who took immediate action.

Right Care: People were protected from abuse and poor care and any concerns were addressed. The service had enough appropriately skilled staff to meet their needs and keep them safe. People were able to communicate with staff and understand information given to them by staff who supported them consistently and understood their individual communication needs.

Right Culture: Staff spoke positively about the culture of the service and told us they placed people’s wishes, needs and rights at the heart of everything they did.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 9 August 2022).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended that the provider refer to current guidance about best practice in end of life care planning. At this inspection we found no one was being supported with their end of life care and support but the registered manager was aware of their regulatory responsibility in relation to best practice guidance.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gain Healthcare on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation about the systems and processes used to ensure the service are not depriving people of their liberties without the correct authorisation from the Court of Protection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

17 May 2022

During a routine inspection

About the service

Gain Healthcare Ltd is a domiciliary care and supported living service providing the regulated activity of personal care. At the time of our inspection there were 15 people receiving the regulated activity of personal care.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

The provider’s systems and processes had not been effective in assessing, monitoring and mitigating risks to the health, safety and welfare of people using the service. The provider had some quality monitoring processes in place, but these had not always been effective as they had not enabled the provider to identify and address the issues we found during the inspection as well as the previous inspection. This placed people at risk of harm.

The provider had not always followed the required safe recruitment practices to help ensure suitable people were employed.

We had concerns from relatives that staff were often late or visits shorter than expected which impacted at times on people receiving the medicines they required.

The provider had failed to ensure there were accurate and complete records in respect of each person, to evidence the care and treatment provided to them was in line with their assessed needs. Records held conflicting information and did not always reflect current best practice of care planning. This meant people were at risk of not receiving the care and support they required.

We have made a recommendation about the provider referring to current guidance about best practice in end of life care planning.

Relatives told us they felt their family members were provided with safe care. They also felt that staff were kind, caring and patient.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

We last inspected this service at the previous premises (inspected 3 February 2021; published 9 December 2021). The service was not rated but there were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We imposed conditions on the provider’s registration to submit information regularly to the Commission.

Since the last inspection the service had moved offices and was registered by CQC at the new address on 14 October 2021. We have used the previous inspection findings to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was the first inspection of the service under the new office registration. Although the address for the service changed following our previous inspection the provider remained the same. They had had full knowledge of the service’s inspection history and were responsible for maintaining and improving the service, including addressing any issues from the last inspection. The inspection was prompted in part due to the concerns identified at the previous inspection with the same provider.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well Led sections of this full report. You can see what action we have asked the provider to take at the end of this report.

Enforcement and recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to regulations 12 (safe care and treatment), regulation 17 (good governance) and regulation 19 (fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We have made a recommendation about the provider referring to current guidance about best practice in end of life care planning.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.