Background to this inspection
Updated
22 June 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team on site consisted of 2 inspectors. After the site visit, an expert by experience made telephone calls to people and relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Gateway Care Services is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection site visit activity took place on 28 April 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.
During the inspection
We spoke with 6 people using the service and 9 relatives about their experience of the care provided. We spoke with 2 care staff, the care manager, a consultant and the Director. We reviewed a range of records. These included 7 people's care records, 5 staff files in relation to recruitment and training and a variety of records relating to the management of the service, including the quality monitoring systems and audits.
Updated
22 June 2023
About the service
Gateway Care Services is a domiciliary care service that provides care and support to people living in their own houses or flats in the community. At the time of our inspection, 33 people were using the service. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
Risks to people’s health and safety were not effectively assessed or guidance available to reduce possible risks and maintain people’s safety. Medicines were not always managed safely. Aspects of people’s care records were not person centred and did not reflect the appropriate support in accordance to people’s needs. The current systems in place were not effective enough to assess and monitor the quality and safety of the services being provided to people.
The service had safeguarding procedures in place. Appropriate recruitment checks had taken place before staff started work; however, some improvement was needed to ensure references obtained for staff were robust. There were enough staff available to meet people’s care and support needs. The service had procedures in place to reduce the risk of infections.
People’s care and support needs were assessed before they started using the service. Staff were supported and received training. We have made a recommendation about staff performance and development. People were supported to maintain a healthy balanced diet and had access to health care professionals when they needed them. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People's privacy, dignity and independence was promoted. People and relatives told us staff were kind and caring.
People and relatives spoke positively about the service and said they felt safe. The service had a complaints procedure in place. No one at the service was receiving end of life care.
The service sought the views of people and their relatives. The service worked in partnership with health and social care providers to plan and deliver an effective service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (Published 12 October 2021).
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gateway Care Services on our website at www.cqc.org.uk.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We have identified breaches in relation to assessing risk, medicines management and good governance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.