Archived: Georgina House Domiciliary Care Agency

Georgina House is a domiciliary care agency that provides care and support to people living in their own homes. At the time of this inspection the service was providing support to 19 people.

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

Lack of governance systems and knowledge of regulatory requirements had meant people who used the service were at risk of receiving care not of the expected quality. Lack of audits had meant the provider was unaware of most of the concerns we identified at this inspection. Where they were aware of poor visit call times, there had been a delay in rectifying this and was ongoing at the time of this inspection. The provider had failed to notify CQC of specified events they are required to by law. At the time of the inspection, the provider had also failed to display the rating from their last inspection on their website; this was rectified shortly after this inspection.

People did not receive a rota so was unaware of which staff would be supporting them and when. Call times for people varied considerably and this meant people were unable to plan their day. Not enough staff were adequately deployed to ensure people received calls at the same specified time each day and this caused them anxiety. Robust checks on staff’s suitability for the role were not in place. Some incidents had occurred which put people at risk and the provider had not reported these to the appropriate stakeholders including the local authority’s safeguarding team. The processes the provider had in place to help protect people from the risk of abuse were not fully effective.

People’s needs had not been assessed in a holistic manner and not all their needs and associated risks had been planned for. Formal reviews of people’s care needs and the service they received were not in place. However, due to people being supported by a small and stable staff team, their personal and emotional needs were met as staff knew them well. 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 and people told us this.

People’s nutritional and healthcare needs were met, and they received their medicines as prescribed. They were protected from the risk of infectious diseases and received information in accessible formats. Staff treated people with respect and kindness, maintained their dignity and encouraged their independence. A complaints policy was in place in the events concerns were raised.

Staff felt supported and morale was good amongst the staff. They received regular supervisions and attended regular meetings which were open arenas for discussion, sharing information and testing knowledge. Mandatory training was not up to date. However, people told us staff were effective and they received a variety of additional training; all had qualifications in health and social care. The service worked with other agencies to meet people’s individual needs.

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 (report published 26 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

At this inspection we have identified breaches in relation to staffing, governance, safeguarding and notifying CQC of specified events.

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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Georgina House Domiciliary Care Agency provides a domiciliary care service to people living in their own homes. At the time of the inspection they were providing a service to 32 people.

There was 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.

We have made a recommendation about the management of medicines. This was because people had received their medicines as prescribed however associated records were not consistently or robustly completed.

The service had procedures in place that minimised the risk of employing people not suitable to work with those that used the service. The provider understood the importance of inducting, training and supporting staff and this was robustly delivered.

The provider was keen to ensure people were happy with the service they received and encouraged an open, communicative and proactive culture. The registered manager regularly delivered care and support to people whilst working alongside staff which ensured accessibility and transparency. Staff told us they felt supported, were happy in their roles and worked well as a team.

People received care and support from staff that were kind, considerate and respectful. They understood the importance of empowerment and worked in a way that ensured people were in control of the decisions made in relation to the care and support they received.

Staff had a good understanding of how to maintain people’s dignity and respected their choices, likes and preferences. Support was provided in a collaborative way that meant people’s independence was promoted, encouraged and supported.

Procedures were in place to help protect people from the risk of abuse and staff had knowledge of these. The risks to individuals had been identified, assessed and managed. Accidents and incidents, although few, had been recorded and appropriately actioned.

The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. Staff had received training in this legislation and had good knowledge of its application.

People had been involved in the planning of their care when they first started to use the service. The care and support delivered was as planned and met people’s needs in a person centred and unhurried manner. However, care plans did not always demonstrate the individualised care people received.

Where required, staff assisted people to meet their nutritional and healthcare needs. They respected people’s choice in regards to nutritional needs and prepared food to people’s liking. Staff had a good understanding of people’s health needs and assisted as required.

The service was well managed and the registered manager had a complete overview of it. Due to their regular contact with people who used the service, relatives and staff, the quality of the service was closely monitored and assessed. This also made the registered manager easily accessible, approachable and in a position to quickly manage any concerns people may have.

The people that used the service, and all others we spoke with, told us they would recommend the service. People received consistent care due to the same staff being in attendance. The service was reliable and caring. People spoke highly of the kindness of staff and the registered manager’s ability to ensure a good quality service was received.