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Gateway Care Services Requires improvement

This service was previously registered at a different address - see old profile

We are carrying out a review of quality at Gateway Care Services. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 9 May 2019

This inspection took place on 9 and 11 January and 15 February 2019. We gave the provider two days’ notice of the inspection as we needed to make sure the registered manager and or staff would be available at the location. This inspection was partly prompted by safeguarding concerns which had impact on people using the service and this indicated potential concerns about the management of risk in the service. While we did not look at the circumstances of specific incidents, we did look at associated risks. At the time of our inspection there were 40 people using the service, however only 38 people were receiving the regulated activity; personal care.

Gateway Care Services is a domiciliary care agency. It provides personal care and support to people in their own homes. Not everyone using the service may receive the regulated activity; personal care. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of our inspection the service did not have a registered manager in post. 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.

At this inspection we found breaches of legal requirements because risks to people's health and well-being were not always managed safely and the provider did not have comprehensive robust systems in place to monitor the quality and safety of the service provided to people. You can see the action we have told the provider to take at the back of the full version of the report.

We have also made a recommendation to the provider about the correct completion of mental capacity assessments in line with the codes of practice and principles of the Mental Capacity Act 2005.

Assessments were conducted to identify, assess and manage risks to people’s health and well-being. However, assessments were not always detailed or provided guidance for staff on how to support people to manage identified risks and this required improvement. There were no systems in place to check when a call was recorded as being missed or late, that staff had attended the call and people had received the support they needed. Medicines were not always managed safely. Staff reported accidents and incidents when they occurred, and these were recorded on the provider’s electronic care planning and monitoring system. However, there was no system of oversight regarding accidents and incidents when they occurred. This meant that trends were not identified so that appropriate action could be taken to reduce the reoccurrence of risk.

Care staff were aware to seek consent from people when offering them support and demonstrated a good understanding of the Mental Capacity Act 2005. However mental capacity assessments were not completed in line with the codes of practice and principles of the Mental Capacity Act 2005. Although the provider did offer new staff the opportunity to shadow more experienced staff members before starting to work with people, they had not yet introduced best practice induction training, in line with the Care Certificate and this required some improvement. Some people were living with diabetes, Parkinson’s or a learning disability and staff had not received training in these areas and this required some improvement.

Although complaints received were recorded and responded to, there were no documented outcomes or learning going forward regarding complaints and this required improvement. Care plans were not always reflective of individuals physical, mental, emotional or diverse needs in line with the protected characteristics of the Equality Act 2010.

There were policies and p

Inspection areas

Safe

Requires improvement

Updated 9 May 2019

The service was not consistently safe

Risks to people's health and well-being were not always managed safely or recorded appropriately.

There were no systems in place to check when a call was missed or late, that staff had attended the call or people had received the support they needed.

Medicines were not always managed or monitored safely.

Staff reported accidents and incidents when they occurred, however there was no system of oversight in place.

There were policies and procedures in place to safeguard people from possible harm or abuse and staff understood their responsibilities to safeguard people.

There were arrangements in place to deal with emergencies and infection control.

There were consistent levels of staff who provided regular care to people.

There were robust staff recruitment practices in place.

Effective

Requires improvement

Updated 9 May 2019

The service was not consistently effective

Mental capacity assessments were not completed in line with the codes of practice and principles of the Mental Capacity Act 2005. We recommend that the provider refers to the Mental Capacity Act 2005 and the codes of practice for current best practice.

Although the provider did offer new staff the opportunity to shadow more experienced staff members, they had not yet introduced best practice induction training, in line with the Care Certificate.

Some people were living with diabetes, Parkinson�s or a learning disability and staff had not received training in these areas.

Staff told us they felt supported in their roles and received regular supervision.

Assessments of people�s care and support needs were conducted before they started using the service and people�s nutritional needs were met where this was part of their plan of care.

Caring

Good

Updated 9 May 2019

The service was caring

People spoke positively about the care they received from staff.

People and their relatives told us they were consulted and involved in planning and reviewing their care.

People told us that staff treated them with respect, supported their independence and maintained their privacy and dignity.

Responsive

Requires improvement

Updated 9 May 2019

The service was not consistently responsive

Although complaints received were recorded and responded to, there were no documented outcomes or learning going forward regarding complaints and this required improvement.

Care plans were not always reflective of individuals physical, mental, emotional or diverse needs in line with the protected characteristics of the Equality Act 2010.

Care plans were reviewed on a regular basis.

People and staff told us they had access to equipment to meet their needs when required.

Well-led

Requires improvement

Updated 9 May 2019

The service was not consistently well-led

The provider failed to ensure there were systems in place to monitor the quality and safety of the service provided to people.

People and staff spoke positively about the management of the service. However, there was no registered manager in post at the time of our inspection.

Staff confirmed that they attended regular team meetings and had the opportunity to discuss areas which effected their work and the service.

There were systems in place to gather feedback from staff, people and their relatives where appropriate.

The service worked with external organisations including health and social care professionals to ensure people�s needs were met.