Golden Keys Care Agency Ltd

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in their needs. People's care records contained information about their preferences, routines, cultural needs and what was important to them. Leaders promoted a person-centred culture and the registered manager told us, "Clients are individuals not a number."

Care plans reflected people's communication needs, family involvement and personal preferences. People's cultural and religious needs were considered when planning care. For example, 1 person's care was arranged around worship activities to support their religious observance, while another person's family was informed when a male care worker would be attending so their cultural preferences could be respected.

Staff and leaders gave examples of adapting care when people's needs changed. Care plans were reviewed and updated to reflect changing circumstances, including increasing support from 1 to 2 care workers when required and reviewing support arrangements when people were no longer able to complete tasks independently.

Continuity of care had been affected by staff turnover and the loss of sponsored workers. Leaders acknowledged some people had received support from a greater number of care workers than intended and were taking action to address this. Some people and relatives told us staffing changes affected continuity because replacement or newly recruited staff were not always familiar with people’s preferences, routines and individual needs. One relative said, “The problems come when [regular staff] are not available, and we have to have replacement carers.” Another told us, “Last week we had 6 different carers covering [person] in 1 week.” In addition, multidisciplinary involvement and communication arrangements were not always clearly documented in care records. This reduced assurance that care was consistently coordinated and supported continuity.

Despite these concerns, the provider understood the diverse health and care needs of people and their local communities, so care was generally joined-up, flexible and supported choice and continuity. Staff worked effectively with health and social care professionals to help meet people's needs. There was evidence that partnership working supported positive outcomes, including when people experienced self-neglect, changes in mobility and moving and handling concerns. Staff escalated changes in people's health and wellbeing appropriately to healthcare professionals, relatives and partner agencies. The provider also recognised the importance of continuity of care and informed people when staffing changes were necessary.

The provider made sure people could access information in a way they could understand. Leaders described adapting communication to meet people's individual needs and making reasonable adjustments where required. People received information through a range of methods, including face-to-face discussions, telephone contact and involvement of relatives where appropriate.

Care records contained information about people's communication preferences and language needs. For example, 1 person who did not have English as their first language was supported by family members to communicate, and leaders told us information could be translated into other languages when required.

The provider listened to people and understood their needs, views and wishes. People and their relatives had opportunities to share feedback about their experiences of the service through reviews and surveys. Leaders told us they contacted people and relatives directly to understand their experiences and check whether any concerns had been resolved.

Managers encouraged people and relatives to raise concerns or provide feedback about the service. Feedback gathered during the assessment included positive examples of staff responding to concerns and adapting care to meet people's individual needs. People and relatives described staff as responsive and told us support was adjusted when their circumstances changed.

The provider made sure people could access the care, support and treatment they needed when they needed it. The provider recognised barriers some people experienced in accessing information and support and made reasonable adjustments to meet individual needs. This included adapting communication for people with sensory loss, communication difficulties and language needs.

The provider operated an out-of-hours system so people, relatives and staff could contact managers when support was needed outside normal office hours. Leaders had identified occasions when calls were not always answered as quickly as they wanted and had introduced measures to improve responsiveness, including providing reassurance that callers would receive a timely response.

Pre-admission assessments were completed before people received support to ensure the service could meet their needs safely and appropriately and identify any adjustments required to support equitable access to care.

There were some shortfalls in how the provider identified and responded to factors that could affect people's experiences and outcomes. As a result, people did not always experience consistent and equitable outcomes.

The provider recognised people's diverse needs and there was evidence cultural, religious and communication preferences were considered within care planning and care delivery. However, systems were not consistently effective in ensuring people received support based on accurate and up-to-date information. We found inconsistencies within care records relating to people's diagnoses, levels of independence and support requirements.

Several care plans required improvement to provide staff with sufficiently detailed guidance in higher-risk areas, including diabetes management, choking risks, mobility, mental capacity and complex health needs. This reduced assurance people consistently received care that reflected their current needs and circumstances.

Feedback from people and relatives highlighted communication difficulties and differences in care delivery between regular and replacement care workers. These experiences affected the consistency of care and outcomes for some people.

There were shortfalls in how people were supported to plan for important life changes and future care needs. As a result, people did not always have opportunities to discuss and record their wishes and preferences for the future.

Future planning arrangements were not consistently developed. Leaders confirmed nobody was currently receiving end-of-life care. However, future planning documentation was absent from people's care records, including for some people receiving palliative support or living with progressive conditions. This reduced assurance that people's future wishes, preferences and changing needs had been fully explored and recorded.

Leaders told us discussions about future wishes did not always take place because people found them difficult to consider. They described involving relatives and healthcare professionals when people's needs changed significantly and said they intended to develop future care planning discussions with people and their families.