5 December 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The first day of the inspection took place on 14 September 2017, however as the provider had only recently moved in to their new premises and were still in the process of having their IT systems installed, we decided it was unfair to continue with the inspection. It was decided that we return at a later date once they had settled in. The second day of the inspection took place on the 09 October 2017 and was announced. The provider was given 48 hours' notice that we would be visiting because the location provides a domiciliary care service and we wanted to ensure that someone would be available. The inspection team consisted of a lead inspector and a second inspector on the 14 September and one inspector on the 09 October.
When planning our inspection we looked at the information we held about the service. This included the recent warning notices, notifications received from the provider about deaths, accidents/incidents and safeguarding alerts which they are required to send us by law. We also looked at information from the local authority commissioning teams to identify any information that might support our inspection.
During our inspection we spoke with three people who use the service, three relative, three care staff members, the registered manager, the office manager, the administration manager and the office administrator. We visited the provider’s office and reviewed the care records of three people to see how their care was planned and delivered, as well as their medicine administration records. We looked at the areas identified in the warning notice. We looked at recruitment, training and supervision records for staff. We also looked at records which supported the provider to monitor the quality and management of the service.
5 December 2017
This inspection took place on 14 September 2017 and was announced. We gave the provider 48 hours’ notice that we would be visiting. This was because the provider offers a support service to people living in their own homes and we wanted to make sure that people and staff would be available to speak with us.
Great Care Home Health Care Services Ltd is a community based adult social care service, registered to provide personal care for persons within their own home. They currently provide a service for 20 people.
There was a registered manager in post at the time of our inspection. 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.
Great Care was last inspected in July 2017. This inspection was prompted in part by the notification of an incident notifying us of the death of a person that was receiving a service. This incident is still being investigated and as a result this inspection did not examine the circumstances surrounding the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of the service and the safety of
people. The service was placed in to special measures and served with a warning notice under Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 - Good Governance. And Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 - Safe Care and Treatment.
At this inspection we saw that the provider had met the requirements of the warning notices and will be exiting special measures.
There were quality assurance and auditing systems in place to ensure continual development of the service for the people being supported by the provider, although improvement needed to be made regarding their implementation.
People were kept safe. Staff had received training and understood the different types of abuse and knew what action they would take if they thought a person was at risk of harm. People were kept safe by staff that were able to recognise the signs of abuse and raise concerns if needed. Staff were provided with sufficient guidance on how to support people’s medical needs.
People were supported by staff that had been safely recruited. People felt they were supported by staff with the appropriate skills and knowledge to care and support them.
Staff had the knowledge and skills to enable them to care for people in a way that met their individual needs and preferences. People were supported to make choices and were involved in the care and support they received. Staff had an awareness of the Mental Capacity Act and Deprivation of Liberty Safeguarding (DoLS).
People and relatives were involved in the development of care plans. People’s specific needs were identified and personalised care was provided in line with their needs.
Staff were caring and treated people with dignity and respect. People’s choices and independence were respected and promoted and staff responded to people’s care and support needs.
People and staff felt they could speak with the provider about any concerns and felt they would be listened to and their concerns would be addressed.