We carried out a review of the data available to us about Golden Key Support Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Golden Key Support Ltd, you can give feedback on this service.
Golden Key Support is a domiciliary care agency. The service provides personal care to older adults and children with additional needs. At the time of our inspection there were 13 people using the service.
Not everyone who used the service received personal care. In this service, the Care Quality Commission can only inspect the service received by people who get support with personal care. This includes help with tasks related to personal hygiene and eating. Where people receive such support, we also consider any wider social care provided.
People’s experience of using this service and what we found
People received care from consistent care workers who arrived on time and met their needs. People told us that they were always able to contact the office for help and advice and were regularly contacted to ensure that they were happy with the service.
There were suitable systems in place to safeguard people from abuse. The provider assessed risks to people’s health and safety and wellbeing, but sometimes risk management plans were not kept up to date as people’s needs changed. The service sought advice and training from other professionals if they were concerned about a person’s safety.
Medicines were safely managed by staff with the right skills to do so. There were effective systems for planning people’s medicines support and checking they had received this as required. Sometimes medicines management plans were not clear about the exact levels of support that people required.
Care workers were recruited safely and the provider ensured that people had enough staff to safely meet their needs and to ensure that they were familiar with who was coming to support them.
The service ensured that care workers understood infection prevention and control and had access to the right equipment to protect people from COVID-19. The service had not been carrying out routine testing as required by government guidance, but since our visit this is no longer recommended for care workers.
Staff had the right training and skills to support people safely, and the registered manager carried out supervision and observations to check staff skills and understanding. People had the right support to eat and drink and the service understood people’s health conditions and how this could affect their support.
The service monitored people’s care through regular communication with people and their families and systems of spot checks and audits. Care workers described feeling well supported by their managers.
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.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was good (published 23 February 2021).
Why we inspected
We received concerns in relation to the planning and recording of care visits. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and Well-led only.
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 not changed following this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Golden Key Support on our website at www.cqc.org.uk
Recommendations
We have made recommendations in relation to how the provider assesses people’s capacity to make specific decisions. We will check if the provider has acted on any recommendations at our next comprehensive inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
This service is a domiciliary care agency. It provides personal care to people living in their own homes. At the time of this inspection the service was providing personal care to 20 people.
People’s experience of using this service
People told us they received safe, timely care. People benefitted from consistent care workers who knew them well and received care from people who understood their communication needs and their language.
The service had made improvements in the management of medicines and how they managed risk. Risks to people’s wellbeing were assessed, and this included when people had health conditions or behaviour which may challenge others. People’s medicines needs were assessed and the service ensured that these were managed safely. Staff were safely recruited and enough staff were available to meet people’s needs. There were appropriate processes to safeguard people from abuse and to learn lessons when things had gone wrong.
Care workers had access to protective personal equipment (PPE) and understood how to use this safely to reduce the risk of transmission of COVID-19. People told us staff used PPE appropriately and maintained social distancing to help keep them safe.
People’s care was planned to meet their needs, and care plans were clear about people’s preferences and how they communicated. People we spoke with gave us examples of how care workers communicated appropriately with their family members, including using objects of reference or Makaton when people were non-verbal. People were supported to access the community in line with their needs when this was part of their plans.
Managers had introduced enhanced systems of audit to ensure good quality recording and to review the quality and safety of the service and had implemented a suitable action plan to address previous shortcomings in the service. People told us that managers contact them regularly to review their needs and ensure they were happy with the service they received. Managers were clear with staff about their roles and responsibilities and used instant messaging and regular team meetings to ensure staff were kept up to date.
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 requires improvement (published 17 December 2019).
Why we inspected
We carried out an announced comprehensive inspection of this service on 3 October 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve person centred care and good governance. We issued a warning notice regarding safe care and treatment.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those Key Questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Golden Key Support on our website at www.cqc.org.uk.
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.
Golden Key Support Ltd is a domiciliary care agency providing care and support to children and adults under direct payment arrangements in several East London boroughs. At the time of our inspection there were 32 people using the service.
People’s experience of using this service
The provider did not always consider how best to meet people’s nutritional needs in line with their preferences and recording did not support this. There was a lack of detailed plans for how to support people with health conditions and sudden changes to their health. Care workers received suitable training and supervision to carry out their roles but not always to respond to changes in people’s health conditions, and managers observed and assessed their practice.
People’s basic care needs were assessed and care plans were followed. The service responded to changes in people’s care needs and checked regularly to see if any changes were needed. Care workers understood how to meet people’s choices and preferences but recording did not always support this. People knew how to complain and complaints were responded to appropriately.
There was not always detailed planning for how to support people with their end of life care. The service was not meeting the accessible information standard to provide information for people in a format relevant to them. People were not supported to have maximum choice and control of their lives and did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
People told us they were treated with dignity and respect by care workers. People’s cultural needs were met and understood by care workers but care planning processes did not always ensure this took place. Care workers gave us examples of how they supported people to make choices and maintain their independence. Care workers worked well with families to deliver care to people.
Processes safeguarded people from abuse and improper treatment. Risks to people’s safety and wellbeing were considered, but sometimes there were not assessments in place to support people when they became upset or agitated or unwell. Care workers were recruited safely.
People’s medicines needs were assessed but sometimes it was not clear how people were to be supported with creams or rescue medicines. There were not enough checks on medicines records to ensure that issues would be addressed promptly.
There was a new manager in place who had applied to be the registered manager. They had identified their immediate priorities for assessing the performance of the service to develop a suitable action plan. Some audits and checks were not being carried out and staff meetings were not taking place, which the manager was planning to address. People and staff told us managers were accessible and helpful. The service had the capacity to deliver learning but did not always promote reflective practice which would help the service to improve.
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 7 June 2018).
Why we inspected
The inspection was prompted in part due to concerns received about the management and quality of the service. A decision was made for us to inspect and examine those risks.
Enforcement
We have identified breaches of regulations in relation to the management of medicines, management of risks, person centred care and good governance.
We issued a warning notice requiring the provider to be compliant with regulations concerning the management of risks and medicines by 4 March 2020.
Please see the action we have told the provider to take at the end of this report.
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.
At our last comprehensive inspection in April 2017 we found breaches of regulations regarding staff recruitment and the management of medicines. We carried out a focussed inspection in September 2017 where we found the provider was now meeting regulations concerning the management of medicines but was still not meeting regulations about staff recruitment.
At this inspection we found the provider had made the necessary improvements and was now meeting regulations. We have changed their rating from “Requires Improvement” to “Good”.
Golden Key Support is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of our inspection there were 25 people using the service. These were primarily older people and people with physical disabilities. The provider had applied to provide support to children with disabilities, but had not started doing so at the time of this inspection.
The service had a registered manager. 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’s needs and preferences for their care and health needs were assessed before they started to use the service, and care plans were designed in order to meet these. Care plans were reviewed regularly to make sure they met people’s needs, and we saw care was delivered in line with these, although we saw a small number of cases where there were discrepancies between what care was planned and what care staff had recorded had taken place. People received support in line with their cultural needs and were supported to have varied diets.
The provider obtained suitable consent to care and had assessed people’s capacity to consent to care, but lacked procedures in the event they needed to document that they were providing care in people’s best interests.
Risks to people using the service were assessed and there were measures to keep people safe. People were safeguarded from abuse, and when there were concerns staff were aware of their responsibility to speak up and had confidence in the manager’s ability to address these. Processes were followed in order to investigate and address complaints and allegations.
The provider followed safer recruitment measures to make sure people were suitable for their roles. People told us that care workers were punctual and reliable, and that they felt treated with respect. People consistently received care from the same care workers, who could meet their cultural and language needs.
The provider had revised their policies regarding the management of medicines prior to their last inspection, and we saw that this improvement was sustained to ensure people received their medicines safely.
Staff told us they felt well supported by managers. Care workers received regular training and supervision to make sure that they had the right skills for their roles.
There were systems in place to make sure people were regularly consulted about their care, both by telephone and in routine home visits. These were used to make sure people were satisfied and whether any aspect of their care needed to change. There were consistently high levels of satisfaction with the service provided.
We undertook this announced focussed inspection on 14 September 2017 to check whether the provider had followed their action plan and made the necessary improvements to meet legal requirements. This report only covers our findings in relation to these areas. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Golden Key Support Ltd’ on our website at www.cqc.org.uk’
Golden Key Support is a domiciliary care agency which provides care and support to older people and people with physical disabilities in East London. At the time of our inspection there were 23 people using the service.
The location had a registered manager. 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.
We found that the provider had met the requirements of the warning notice regarding staff recruitment. We had issued this notice as we found that five staff were working for the agency who had fraudulent references from previous employers, and that the provider had failed to carry out a risk assessment for a staff member who had information of concern on their background check. At this inspection we found that the provider had obtained alternate references for these staff and made calls to confirm that references were genuine, and that they had carried out a suitable risk assessment for this staff member. They had introduced a system for verifying that background checks were in place before a staff member was signed off to start work. However, the provider was still not meeting this regulation, as although they had obtained references for staff, we found that some care workers’ references did not provide satisfactory evidence of previous employment in health and social care.
At our previous inspection we found that the provider was not meeting regulations regarding the safe management of medicines. We found that the provider was now meeting this regulation, as they had obtained suitable medicines administration charts for people they were supporting, and these were now fully audited by the registered manager to ensure that they were properly completed. Relatives of people who used the service were positive about the changes made by the provider.
We found one breach of regulations relating to staff recruitment and you can see what action we told the provider to take at the end of the full version of this report.
Golden Key Support is a domiciliary care agency which provides care and support to older people and people with physical disabilities in their own homes. At the time of our inspection there were 20 people using the service across three East London boroughs, who accessed the service through direct payments. The majority of people had started using the service in the last four months.
The service had a registered manager. 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.
The provider had measures in place for protecting people from abuse, and had carried out detailed risk assessments in order to mitigate risks to people who used the service. There was information on how to meet people’s health needs and ensure that people received the right support with nutrition. The provider had assessed people’s needs with regards to medicines, however medicines were not safely managed or audited in a way which could detect errors.
Pre-employment checks were carried out on staff, however, we found that safer recruitment processes were not always being followed, and some staff were working with fraudulent references from previous employers.
Care was planned and delivered in a way which met people’s needs, and people who used the service and their relatives praised the quality of the service. People told us that staff were punctual and reliable, and that the service could accommodate changes in times. People had consented appropriately to their care and the provider had assessed people’s capacity to make decisions about their care. People told us they were very happy with the care provided and would recommend the service to their friends.
People were involved in their care planning and benefitted from very consistent staffing. There were systems in place for responding to complaints appropriately.
Staff were well supported by managers and received appropriate shadowing, training and supervision in order to carry out their roles, including assessing staff training to meet the needs of individuals. There were systems in place to check that care was being delivered safely, including spot checks and regular telephone monitoring, and care records were audited to make sure that this was accurately recorded.
We found two breaches of regulation in relation to the safe management of medicines and failing to carry out appropriate pre-employment checks to ensure that staff were suitable for their roles. We issued a warning notice in relation to the provider's recruitment processes. You can see what action we told the provider to take at the back of the full version of this report.