This inspection took place on 26 and 28 June 2017 and 04 July 2017 and was announced. Great Care Home Health Care Services Limited is a domiciliary care service which offers support to people in their own homes.
At the time of our inspection there was a registered manager in post. A registered manager is a person who has registered with the CQC 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.
People were not always kept safe because staff practices had not always ensured security was maintained when staff visited people by ensuring doors were locked and keys kept safe. Staff had received the appropriate training so they knew how to recognise any form of abuse. However, some staff were not sure where the information should be recorded to protect a person from further harm. People did not always receive their calls as planned and systems were not effective to ensure missed calls were identified, so that people were at risk of not having their care call.
Recruitment and induction processes were in place but the necessary monitoring to ensure that staff did not work alone until all the checks had been completed was not undertaken.
Risk were not always managed effectively to ensure people were kept safe. Risks to people who were supported to take their medicines had not been identified to ensure staff supported people to take their medicine as prescribed.
People were treated with respect and dignity at all times but staff did not fully understand person centred care so that people were provided with care that met their individual needs, preferences and choices.
People's capacity to make decisions was not always assessed and the provider’s systems meant that people were not consistently involved in planning their care.
Complaints were not monitored to prevent reoccurrences and records management in relation to complaints received did not evidence that they had been investigated and action taken.
Quality monitoring and audits had failed to identify that a number of areas of the service provision was not meeting the fundamental standards of care. Information provided by the registered manager was unreliable and didn’t reflect the findings of this inspection.
You can see what action we told the provider to take at the back of this report.
The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'.
The service will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.