Golden Keys Care Agency Ltd

Golden Keys Care Agency Ltd is a large domiciliary care agency providing the regulated activity of personal care to people living in their own homes. At the time of our inspection there were 95 people using 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.

People’s experience of using this service and what we found

The provider had made improvements to their processes for monitoring and auditing the quality and safety of the service since the last inspection. However further improvements were required in relation to communication and gathering people’s feedback and using this information to improve the quality of the service being provided. Risks to people had been identified and assessed, however some risk assessments were not dated which made it difficult to ascertain when they had been completed or reviewed. We have made a recommendation around this.

People told us they had not had any missed calls, however on occasions the calls were not at their scheduled times. People and their relatives told us they felt safe using the service. People were cared for by staff who knew how to keep them safe and protect them from avoidable harm.

Effective arrangements were in place to ensure recruitment checks on staff were safe. Staff had received an induction and training to enable them to meet people’s needs. Supervisions, appraisals, and competency assessments for staff were carried out and staff told us they felt supported by the senior team.

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.

The provider was very receptive to the feedback provided and was fully aware of the required improvements they needed to make to improve the quality of the service.

Rating at last inspection and update

The last rating for this service was requires improvement (published 13 April 2023) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found sufficient improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check whether the Warning Notices we previously served in relation to Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met about providing safe care and treatment and monitoring the quality of the service and to see if 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 and Well-led which contain those requirements. 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 remained 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Golden Keys Care Agency Ltd on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation about the completion of risk assessments.

Please see the action we have asked the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Golden Keys Care Agency Ltd is a large domiciliary care agency providing the regulated activity of personal care to people who live in their own houses and flats. At the time of our inspection there were 90 people using 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.

People’s experience of using this service and what we found

People told us they did not always receive their care calls on time and staff did not always stay for the duration of the scheduled call time. People were not always notified about delays or changes to their care.

Recruitment processes were in place; however, these were not robust as we identified several gaps in people’s employment history’s where these had not been explored by the registered manager during the recruitment process.

Risks to people had not always been identified, assessed and reviewed. We found the provider did not have robust processes in place to minimise the potential risk of harm to people. People’s medicines were not always managed safely and the providers systems and processes for auditing people’s Medication Administration Records [MAR] was not effective.

The providers governance arrangements did not provide assurance the service was well led. We were not assured the systems and processes in place to oversee the quality assurance of the service were robust and effective, as they had not identified the shortfalls we found during our inspection and regulatory requirements were not always being met.

People and relative’s we spoke to, some were unsure if they had received a copy of the complaints procedure for the service but knew how to raise a concern or complaint. None of the people we spoke to knew who the actual registered manager was.

Staff knew how to keep people safe from harm. People told us they felt safe when staff were providing care. Staff had received training in Infection prevention control. Staff had access to personal protective equipment (PPE), and people told us staff wore their PPE when providing their care.

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 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 29 June 2018). The service is now requires improvement.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We received concerns in relation to people's care and treatment. As a result, we undertook a focused inspection to review the key questions of safe 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 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Golden Keys Care Agency Ltd on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to assessing and monitoring risk to keep people safe from harm, recruitment processes and good governance at this inspection. 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 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 next inspect.

Golden Keys Care Agency Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to adults in the local area. There were 49 people using the service at the time of this inspection.

This was the services first inspection. 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.

People received their care and support safely. Care workers understood how to support people and knew how to protect them from the risk of harm. The service recruited people safely and employed sufficient care workers to meet people’s needs. People received their medicines safely as prescribed and the records were of a good standard. Care workers had a good understanding of how to minimise the risk of infection, they had been trained, and had access to personal protective equipment such as gloves and aprons.

People’s care needs had been assessed and their care plans reviewed as their needs changed. Care workers were well trained and supervised and they knew how to support people effectively. People were supported to eat enough food, and drink sufficient fluids. When necessary, care workers ensured people’s healthcare needs were met. The service worked well in partnership with other professionals to ensure that people received the health care support they needed.

The service worked in line with other legislation such as the Mental Capacity Act 2005 (MCA) to ensure that people had as much choice and control over their lives as possible. The service had carried out appropriate assessments in line with legislation.

People were supported by kind, caring and compassionate care workers. Their independence was encouraged as much as possible while minimising any risks to help keep them safe. People felt their care workers gave them the time they needed and respected their dignity and privacy. People and their relatives were very complimentary and said that care workers were trustworthy, professional and flexible. They told us they were kept involved in decision-making. Advocacy services were available if people needed them. An advocate supports a person to have an independent voice and enables them to express their views when they are unable to do so for themselves.

People received personalised care that was responsive to their needs and care plans and daily notes were detailed and informative. There was a good complaints procedure and people had confidence that any complaints would be dealt with quickly.

People felt the service was well led. They knew who the registered manager was, and had confidence in them. Care workers were well supported and happy in their work. The quality assurance systems were effective and the registered manager learnt from audits and investigations and made the necessary improvements. Confidential information was stored safely in line with data security standards.

Further information is in the detailed findings below.