During an assessment under our new approach
Date of assessment: 17 November – 16 December.
Heart of Gold Homecare is a domiciliary care agency who at the time of the inspection were supporting 32 people, 16 of which were receiving personal care as a regulated activity. A regulated activity is an activity relating to health or social care that is prescribed in the Health and Social Care Act 2008 (Regulated Activities) regulations 2014 and requires registration with the CQC. The service provided support to autistic people and people with a learning disability. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.
There were 3 breaches of regulation identified at this inspection which were in relation to safe care and treatment, safeguarding and good governance.
The provider’s management of safety incidents required improvement. Not all staff had a good understanding of safeguarding, and some safeguarding concerns had not been escalated appropriately. The registered manager was completing competency assessments with staff but did not have the appropriate qualifications to do so. Staff had access to training in key skills, but some staff’s completion rates were low. Audits for infection prevention and control and the person’s home were not up to date. Medicines management required improvement. However, staff assessed risks to people, acted on them and kept good care records.
Staff supported people with eating and drinking, however there were some improvements required. Some policies and procedures required a review, the outcomes of people needed closer scrutiny, the service needed to work more closely with healthcare providers such as district nurses, and staff required further training and knowledge of the key conditions they were supporting. However, staff worked well together for the benefits of people they were supporting, advised them on how to lead healthier lives and understood the importance of consent being sought.
Staff supported people to maintain their independence, choice and control. The provider supported staff to stay well and had appropriate measures in place to ensure this.
People’s care plans, risk assessments and daily notes, overall, were person centred. There were appropriate systems in place to ensure people and their relatives could provide feedback. The registered manager was knowledgeable about how people the provider was supporting were likely to be discriminated against.
The provider had visions and values, although some were not being fully achieved. The registered manager had not identified the key issues identified during the inspection. The systems used were unreliable in identifying key concerns. Continuous improvement was considered but this was made difficult due to the audit systems not being as effective as they should be. The provider did not always work effectively with other partners. However, the staff felt respected, supported and valued and felt there was a good culture. Staff were aware of how to raise concerns including ‘speaking up’. The registered manager ensured staff were treated equally and fairly.
We have asked the provider for an action plan in response to the concerns found at this assessment.