Archived: Golden Heart Healthcare Services Limited

Updated 9 June 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, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 10 February 2017 and was announced. We gave the registered manager 24 hours’ notice to ensure they were available when we visited. It was undertaken by a single inspector.

Before our inspection we reviewed information we held about the service and the provider. We received information of concern from another government body that the provider may be employing staff who do not have the right to work in the UK. We also contacted the local authority safeguarding team to ask them about their views of the service provided to people.

During the inspection we spoke with the registered manager. We looked at four people’s care records to see how their care was planned and delivered, 13 staff recruitment files and records relating to the management of the service.

After the inspection we spoke with two people using the service and two members of staff to gather their feedback.

Updated 9 June 2017

This announced inspection took place on 10 February 2017. The provider was given 24 hours’ notice. This was to ensure the registered manger would be available to provide us with the necessary information. At our last inspection on 6 and 8 September 2016 we found the provider was breaching the regulations relating to safe care and treatment, staffing, fit and proper persons employed and good governance. Following the inspection they sent us an action plan in which they told us they would make all the necessary improvements by 1 February 2017.

We undertook this focused inspection to check that they had followed their action plan and to confirm that they now met legal requirements. In addition we received some information of concern prior to the inspection alleging that the provider was using staff who did not have the right to work in the UK which we also intended to check.

This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Golden Heart Healthcare Services on our website at www.cqc.org.uk

Golden Heart Healthcare Services provides domiciliary care to older people living in their own homes in and around South London. Some people received live-in care. Several people were living with dementia and some had physical disabilities. Our inspection findings indicated there were 12 people using the service at the time of our inspection, although we were unable to confirm this. This was because the number of people the registered manager told us were receiving a service initially did not match numbers shown on staff rotas and in information the registered manager sent us after the inspection. This indicated the service was not managed effectively.

The service has a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

At our last inspection we identified people were at risk of receiving care from staff who may be unsuitable. During this inspection we found that two staff recruited since our last inspection had no recruitment documents on file which indicated the registered manager had not carried out any checks on their suitability. In addition other staff did not have references, criminal records checks, proof of address and evidence of the right to work in the UK. We forwarded this information to UK Border Agency (UKBA) for further investigation. In addition we raised a safeguarding alert with the local authority due to concerns of people receiving care from staff who had not been checked thoroughly to ensure they were suitable to work in this sector.

Although the provider had reviewed risk assessments relating to people’s individual needs these were insufficient. They did not always follow Health and Safety Executive (HSE) guidance and there was a lack of guidance for care staff on how to reduce risks to people. The were no suitable risk assessments in place relating to some people’s risks which meant the provider could not be sure they were doing everything possible to mitigate risks to people.

The registered manager had put in place an induction for new staff and told us they would use the Care Certificate so new staff would reach a nationally recognised standard of skills and knowledge during their induction for new staff starting after 1 February 2017. The registered manager put a training programme in place to include annual mandatory training for all staff in topics such as safeguarding, medicines administration and first aid. However, staff did not receive training or competency assessments in using hoists safely even though one person required a hoist to transfer. In addition staff were not receiving formal supervision and appraisal from the registered manager to help them develop in their role. This meant people were at risk of receiving unsafe care from staff who had received inadequate training and support from the registered manager.

The provider had not put in place quality assurance processes to ensure internal systems and processes were checked so the service could continually learn and improve practice. The provider still did not have suitable arrangements in place to seek feedback from people, and also from staff, on the service.

The provider had not notified the CQC of significant events including an allegation of abuse as required by law.

At this inspection we identified repeat breaches of Regulations 12, 17, 18, 19 of the Health and Social Act (2008) Regulated activities and a new breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. We have taken urgent action and we are taking further action against the provider in relation to the repeat breaches of regulations and this will be added at the back of this report after representations and appeals processes have concluded You can see the action we took in relation to Regulation 18 of the Care Quality Commission (Registration) Regulations 2009 at the back of the full version of this report.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’. Services in special measures 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. Where necessary, 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.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.