Gain Healthcare Ltd

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to Requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to person-centred care, staffing and governance.

This service scored 45 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always treat people with kindness, empathy and compassion, or consistently promote a culture where people felt respected. Relatives told us they were not always treated in a way that made them feel valued or listened to.

Relatives we spoke with described an incident where staff raised their voices during a challenging situation, which they felt contributed to the situation escalating. We heard this experience left the person distressed and undermined their confidence in how the service responded to people’s needs.

There were limited assurances that interactions were effectively monitored by the provider.

Some staff told us they did not always feel supported in their roles, including how communication was managed within the service. They described occasions where interactions felt abrupt or strained, which affected how confident they felt in raising concerns or seeking guidance.

However, we also heard that several staff were caring and had taken the time to get to know their relative well, demonstrating positive and compassionate practice.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The care plan contained important information about how to support them, including the need for familiar adults who understood the person’s speech patterns to interpret their verbal expressions accurately. However, the care plan did not include the specific detail required to help staff understand these expressions.

Relatives told us they were not always provided with staff rotas in advance. The person required at least four days’ notice of which staff would be attending their home in order to feel prepared, reassured and supported. The provider did not consistently take this into account. As a result, care was not always delivered in a way that respected the person’s individual needs, preferences or emotional wellbeing.

The provider did not consistently adapt care delivery to meet people’s unique needs, which negatively impacted people’s experiences and wellbeing.

The provider did not always promote people’s independence, which meant people did not always know their rights or have choice and control over their own care, treatment and wellbeing.

Care planning documentation outlined communication strategies to promote choice, such as the use of choice boards, written prompts, and ensuring the person had enough time to process options in order to made choices. However, we did not see communication aids used in practice and the care planning did not consistently evidence that peoples individual needs or preferences has been fully considered.

In addition, the person did not always receive support from a regular team. This made it difficult to ensure staff had the necessary understanding of the person’s communication style and preferences, limiting the extent to which their independence could be effectively promoted.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always have the necessary guidance to respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Care plans include information about how the person expressed their feelings, including frustration or anxiety and the support they required. This included details of known triggers and guidance on how staff should respond to help keep the person safe and reduce distress. However, daily notes documented further aspects of support required which had not been identified as part of audits and included in the persons care plan. The care plan also stated that staff should follow the person’s sensory support plan, however, this document was not available to staff.

Staff supporting the person had not received the necessary training to respond to the persons immediate needs effectively. Staff told us they had not received effective information, training or support to understand the person’s needs. Staff told us about one incident where they did not feel equipped to safely support the person during a period of distress. Staff also reported that they often felt they had to “learn on the job,” which increased the risk of inconsistent or unsafe responses to people’s needs.

The provider did not always promote the wellbeing of their staff or ensure they were supported to deliver person‑centred care.

The care plan contained limited information about how staff should keep themselves safe. Staff told us there were no debriefs following incidents, which meant they were not always able to reflect on events or receive support after challenging situations. We asked for evidence of support provided for staff following incidents, however this was not available.

We did see some examples of supervision taking place. Where concerns had been raised by staff, there were some documented actions being taken, however, there were also examples where staff raised concerns around being physically assaulted at work and feeling exhausted, there were no supportive measures in place to address staff well-being.

One staff member told us they were not routinely checked on and that managers did not regularly reach out to them. Staff felt they had to check on each other as there was no clear supervision system in place.