Golden Years Care Ltd

Golden Years Limited is a domiciliary care agency providing personal care to and nursing care to people living in their own homes.

Not everyone who used the service received personal care. 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

Not all staff had received recent training on the administration of medicines. Care plans did not guide staff on the side effects on medicines administered. We have made a recommendation about this. People told us they felt safe and they received their medicines on time.

People received regular reviews of their care needs. Staff received training at the start of their employment to ensure they had the skills to provide effective care. However, the provision of ongoing training had lapsed. The provider had recently started to introduce new training for staff. Staff felt very supported by the manager and management team. We saw the provider worked with community health professionals to ensure people received effective care.

The registered manager used a variety of methods to assess and monitor the quality of the service. However, not all errors were noted and acted upon. We discussed this with the registered manager who said they would review their processes. People, staff and relatives spoke positively about the registered manager and management team. There was a positive culture throughout the service which focused on providing care that was individualised. They were aware of their regulatory responsibilities associated with their role.

Staff told us they knew how to manage risks effectively and identify signs and symptoms of abuse and who to report concerns to. The registered manager had robust recruitment procedures and staffing levels delivered responsive support to people. Staff had access to protective equipment to protect people from the risk of infections.

People told us staff treated them with dignity and were respectful. Care plans held personalised information about people likes and dislikes and how they liked to be supported. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Care plans held personalised information that reflected people’s personalities and promoted independent living. One relative told us, “We are very happy and would recommend the service without hesitation. It gives us peace of mind and it’s very personal and they take time to sit and chat with [family member] which is great.”

The service was willing and able to support people with activities. There was a complaints policy that supported positive engagement and timely action. Should it be required end of life care could be provided. Continuity of care was promoted by the service, so people were supported by familiar staff.

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 22 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager at the service. 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.

They were the last inspected on 9 December 2015 and were found to require improvement. People’s capacity to make their own decisions had not always been assessed. At this inspection capacity was assessed and staff understood how to support people to make their own decisions, or how decisions could be made in their best interest. At the last inspection the provider did not always ensure that measures were followed to ensure that new staff were safe to work with people. At this inspection, safe recruitment procedures were in place and were followed by the provider.

Risks to people’s health and wellbeing were assessed and plans were in place to monitor people and to assist them in a safe manner. They described how to support people safely, including using equipment to assist them to move. Some people received assistance to take medicines and records were kept to ensure that this was done safely. When people required assistance to eat and drink, the provider ensured that this was planned to meet their preferences and assessed need.

Staffing levels were planned around individuals to meet their needs. Care was planned and reviewed with people and the provider ensured that people and their relative’s choices were followed. People’s privacy and dignity were respected and upheld by the staff who supported them.

Staff were supported and trained to ensure that they had the skills to support people effectively. They understood how to protect people from harm and were confident that any concerns would be reported and investigated by the manager.

People had caring relationships with the staff who supported them. They were supported to eat and drink meals of their choice when appropriate. The provider had built relationships with other health and social care professionals to ensure that people were supported to maintain good health.

People were asked for their feedback on the quality of the service and their contribution supported the development of the service. There was a complaints procedure in place and any received were investigated and responded to in line with it. There were other systems in place to monitor and drive improvement such as audits.

At our last inspection we saw that the provider did not have consistently effective recruitment procedures in place. At this inspection some improvements were needed to ensure that the provider gathered all available information to confirm that new employees were of good character and suitable to work with people.

At our last inspection we saw that risk was not always managed consistently because they were not regularly reviewed. At this inspection we saw that risks were assessed, managed and reviewed to assist people to maintain their independence in their own homes.

At our last inspection we saw that staff training was not consistently effective. At this inspection people and their relatives told us that they received support from knowledgeable, skilled staff. Staff felt equipped to provide a good service through regular supervision and training opportunities. They told us there was an open inclusive culture and they could ask the manager for support at any time.

At our last inspection we saw that the provider did not provide a consistently effective service because they did not review the care that was planned with people. At this inspection people told us that they had their care reviewed regularly and that they received care that was centred on their needs.

At our last inspection we saw that quality audits were not consistently effective. At this inspection we saw that quality checks were in place which audited the effectiveness of the service and drove continuous improvement.

We looked at the principles of the Mental Capacity Act 2005 and found when people were unable to consent to their care, mental capacity assessments and best interest decisions were not completed.

The service had a registered manager in place. 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.

People told us that they were supported to keep safe. Staff were knowledgeable about protecting people from abuse and knew how to report any concerns. There were sufficient staff employed to meet peoples’ needs. People told us that the care they received was good and that the staff were caring. People received continuity of care from staff who knew them well and were able to build relationships and trust. Their privacy and dignity was respected.

People were supported to manage their medicines by trained, competent staff. There were systems in place to monitor their intake of food and drink and staff knew how to refer people to healthcare professionals for further support. .

Peoples’ views and feedback were welcomed and used to improve the service. People told us that they knew the manager and felt confident that any concerns they raised would be resolved promptly.

You can see what action we told the provider to take at the back of the full version of the report.

The support was provided by skilled staff who knew the needs of people well and what to do to assist them. People said they had no concerns about the service and knew how to raise concerns should they need to.

The staff received training that was appropriate for their individual needs and provided them with the information they needed to care for the people living in their own home.

Quality monitoring systems were in place whereby the quality of the care was reviewed and monitored. Formal systems to review the service were not completed and people's views were not formally gained to influence the development of the service.

People were happy with the service they received. They said that they had regular care workers that knew their needs and provided their care in the way they wanted. People had an individual plan of care although this was not always kept up to date.

People told us that they trusted their care workers and felt safe. They were confident that the agency would act on any concerns that were raised.

People were complimentary about their care workers and felt they had the skills to provide their care. Staff received training to make sure that they had the knowledge and skills to provide people with the care they needed.

The agency was undertaking a number of checks to make sure that people were receiving appropriate care although there was no formal system in place and not all checks were fully recorded.