Golden Keys Care Agency Ltd

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has remained Requires Improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to governance at the service.

This service scored 61 (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's values and expectations were not consistently embedded across the workforce. Relatives reported concerns about staff turnover, continuity of care and some staff's understanding of people's needs and preferences. One relative said, “There is too much of a turnover of staff.” Another told us, “The whole service drops when other carers come in.” These experiences showed people did not always receive consistent, person-centred care when regular staff were unavailable, demonstrating a gap between the provider's stated values and people's day-to-day experience of care. Although leaders had recognised recruitment and continuity challenges and identified actions to address them, improvements were not yet fully embedded or sustained.

Despite this, leaders promoted a culture of dignity, respect and person-centred care. The registered manager told us, “I want to be an excellent service and do that extra mile to get there.” Some people spoke positively about their care. One person said, “I feel really supported, they give me a really good feeling.” Another told us, “They are all friendly, helpful, understanding, caring and most of all they have a laugh and cheer me up.”

The provider did not always have effective leadership and oversight of the service. Leaders had systems in place to monitor and improve quality, including audits, action plans, staff meetings, supervision, competency assessments and spot checks. Leaders had recognised challenges and were taking action to improve recruitment, staff training and care planning. However, these arrangements were not yet fully embedded or consistently effective. We found shortfalls in care planning, risk management, medicines records, workforce assurance and the monitoring and completion of actions. Although actions had been identified in some areas, there was not always clear evidence of follow-up, verification or sustained improvement.

Despite these shortfalls, leaders were visible and people and relatives described positive management involvement. One relative told us, "We do have regular meetings to make sure everything is going ok with the visits." Another person said, "About every 6 months I see the [manager]. They come round to see if everything is on track." The registered manager described their approach to supporting staff and told us, "The more you empower your staff the better we will do."

The provider promoted a culture where people, relatives and staff were encouraged to raise concerns and share feedback. Leaders had whistleblowing and safeguarding policies in place and reminded staff how to raise concerns through induction, supervision and meetings. The registered manager said, “I will listen and treat [concerns] confidentially."

Staff were confident raising concerns and leaders provided examples where action had been taken and learning shared. The registered manager told us,"[Staff] have confidence in raising anything with us."

People and relatives generally knew how to raise concerns and described managers as accessible. One person said, “I have no problem in speaking up if I need to." A relative told us, “I spoke to the manager and [concern] was sorted out."

Although some relatives felt concerns did not always lead to lasting improvements, there was evidence that managers responded to feedback and took action when issues were identified. Overall, systems and processes supported an open culture where people, relatives and staff could speak up.

The provider generally promoted equality, diversity and inclusion for people using the service and within the workforce. Leaders described supporting a diverse workforce and maintaining regular communication with staff. The registered manager said, "We want staff to feel valued and part of the organisation."

Leaders demonstrated consideration of staff wellbeing and provided support where needed, including flexibility around family commitments and assistance during periods of financial difficulty. Managers also sought feedback from staff and encouraged constructive challenge.

Although leaders had limited evidence of formally monitoring equality and diversity initiatives, there was evidence they promoted inclusion in practice and supported staff and people in ways that respected their individual needs.

The provider did not have effective governance and management arrangements to ensure good quality and sustainable care. Governance and quality assurance systems were in place, including audits and monitoring processes. However, these systems were not always effective in identifying and addressing concerns with care planning, risk management, medicines management, consent and Mental Capacity Act records, workforce records and quality assurance.

We found incomplete and inconsistent care records, risk assessments that did not provide sufficient guidance for staff, gaps in consent and Mental Capacity Act documentation, discrepancies in workforce records and significant concerns with medicines governance. The provider's governance arrangements had not identified or effectively addressed these shortfalls.

Leaders recognised areas that needed to improve and had started to take action. However, at the time of our assessment, oversight arrangements had not ensured all concerns were identified and addressed or that improvements were embedded and sustained.

The provider worked in partnership with external organisations and professionals to support people's care and wellbeing. Leaders described positive working relationships with local authority teams and health and social care professionals. Managers told us these relationships had supported service improvements and helped address previous challenges.

Leaders provided examples of working with social workers, occupational therapists, district nurses and safeguarding teams to manage risks, respond to changes in people's needs and support positive outcomes.

The provider engaged with external networks and learning opportunities, including local provider forums. Leaders also described plans to strengthen their involvement within the local community and develop links with community organisations and dementia-related initiatives.

Although leaders identified opportunities to further develop community engagement, partnership working was effective and supported the delivery of coordinated care, service development and improved outcomes for people.

The provider did not always have effective systems to support learning, improvement and innovation. The assessment identified concerns relating to care planning, risk assessments, medicines records, consent documentation and workforce records that had not been identified or addressed through governance systems and processes. This demonstrated learning from audits, oversight and other governance activities was not consistently embedded or used to drive sustained improvement. Feedback from relatives also indicated improvements were not always reflected in practice, particularly when replacement carers provided support. These findings showed learning was not consistently translated into improved outcomes and experiences for people using the service.

Leaders demonstrated a willingness to learn and improve. They described learning from incidents, safeguarding concerns, complaints and feedback, which was shared through staff meetings, memos and training. The registered manager told us, "We take every opportunity to learn something from things so have lessons learned, whether positive or negative feedback, complaint, safeguard and we share and make sure no incidences never happen again." Leaders also implemented improvements in response to identified concerns, including introducing face-to-face moving and handling training and increasing flexibility in staff meeting arrangements to improve attendance. However, governance systems had not consistently ensured learning was embedded, monitored and translated into effective and sustained improvements across the service.