21 March 2023
During an inspection looking at part of the service
About the service
Guardian Homecare is a domiciliary care service providing personal care to people who live in their own houses and flats. At the time of our inspection, people were being supported by 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.
The service also provides care and support to people living in a supported living setting, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at personal care and support. Support is primarily provided to people with learning disabilities and autistic people. People live in shared houses.
People's experience of using this service and what we found
The provider was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right Support
Staff did not always support people with their medicines in a way that promoted their independence.
People were supported to make decisions and staff communicated with people in ways that met their needs. Staff supported people to play an active role in maintaining their own health and wellbeing.
Right Care
Staff understood how to protect people from poor care and abuse and how to recognise and report any concerns.
Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.
Right Culture
The provider did not have effective systems in place to monitor the quality and safety of the service. For example, we found concerns with the provider's oversight of call times and medicines management.
Not all staff had felt valued and supported but this was improving following the involvement of the provider at the service.
People and those important to them, were involved in planning their care; however, we received some mixed feedback about how well the provider communicated with others.
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 March 2018).
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support, right care and right culture.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
Enforcement and recommendations
We have identified breaches in relation to medicines management and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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 inspect next.