Golden4 Care Also known as 36 Queens Way

Golden4 Care is a domiciliary care service providing personal care to people in their own homes. There was one person using the service at the time of the inspection.

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

The relative of the person using the service was happy with the standard of care provided. They said the care workers knew the person's needs well and thought the standard of care provided was good.

Medicines were not managed safely due to a lack of details and accurate information in the risk assessment and medicines administration records. Care workers followed the presciber's directions but the records and management oversight did not reflect the actual practice.

The management team carried out checks to monitor the quality of care people received however the auditing of medicines records was not effective as the lack of detailed information about the medicines had not been picked up.

The service's recruitment procedure was not followed robustly.

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.

Care workers were trained, supervised and subjected to spot checks to ensure they were providing safe care. They also had annual appraisals.

Rating at last inspection and update

The last rating for this service was Requires Improvement (published January 2021) and there were three breaches of regulations identified. The concerns related to the unsafe management of people's risks and medicines, poor recruitment processes and failure to effectively assess risks and the quality of the service.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. We served a warning notice due to the breach of regulation about good governance.

After the warning notice we received information indicating improvements but at this inspection we found not enough improvement had been made and there were continued breaches of regulations at this inspection. The service remains rated as requires improvement.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan, complied with the warning notice and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of safe, effective and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions were not looked at on this occasion but were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. 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 Golden4 Care on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care (medicines), staff recruitment and governance at this inspection.

You can see what action we have asked the provider to take at the back of this report. In response to the breach identified regarding good governance, regulation 17, we will be writing to the provider asking them to provide an action plan in response to the issues identified and to provider time specific updates on the progress of actions taken.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Golden4 Care is a domiciliary care service providing personal care to people in their own homes. There was one person using the service at the time of the inspection.

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

The person using the service and their relative were very happy with the standard of care provided to them. They had formed good relationships with the care workers and found them to be caring and helpful.

Medicines were not managed safely due to a lack of clear detail in the directions and risk assessments about supporting people with their medicines. The service had not identified risks associated with the person’s medicines or health conditions.

The management team carried out checks to monitor the quality of care people received however the auditing of medicines records was not effective as spelling errors in medicine names had not been corrected and the lack of information about the medicines had not been picked up.

Pre-employment checks to ensure staff were safe and suitable to work with vulnerable people were not always carried out properly before staff commenced employment and were not all verified by the provider.

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.

Care workers told us they found their training helpful and they felt well supported by the registered manager and another senior staff member. The service had started carrying out appraisals since the last inspection and care workers were subject to spot checks in the person’s home to see that they were carrying out their duties as required.

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 13 February 2020) and there were three breaches of regulations identified. The concerns related to the unsafe management of people's risks and medicines, poor recruitment processes and failure to effectively assess risk and quality of the service.

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 not enough improvement had been made and there were continued breaches of regulations at this inspection. The service remains rated as requires improvement

Why we inspected

We carried out an announced comprehensive inspection of this service on 18 December 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 in the areas of safe care, medicines, staff recruitment and management of the service.

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, effective and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions were not looked at on this occasion but were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. 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 Golden4 Care on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care, staff recruitment and management at this inspection. We also made four recommendations. These were to update the service's infection prevention and control policy, ensure written consent to care is recorded, include information about nutritional needs in care plans and address people's equality characteristics.

You can see what action we have asked the provider to take at the back of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Golden4 Care is a domiciliary care service providing personal care to six people in their own homes at the time of the inspection. This service was registered with us on 29 January 2019 and this is the first inspection.

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

There were some risks to people’s safety as their risk assessments did not contain enough detail in areas such as moving and transfer and epilepsy. This meant that new care workers might not have all the information they need to care for the person safely. Medicines were not managed safely due to poor recording and a lack of clarity about who was taking responsibility for supporting people with their medicines. The management team carried out checks to monitor the quality of care people received however the auditing of medicines records was not effective.

Pre-employment checks to ensure staff were safe and suitable to work with vulnerable people were not always carried out before staff commenced employment. 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. People currently using the service said they were happy with the care they received from their small team of care workers.

People and relatives told us that staff were generally on time and where they were running late they were always informed of this.

Care workers completed an induction training and they told us they thought the training was helpful and they felt well supported by the registered manager. The service had not been operating long enough to carry out appraisals and individual staff supervisions were not recorded.

People were supported with eating and drinking and told us they were happy with the way they were supported. The service supported people with health needs and helped them to get medical assistance where required.

Complaints were recorded, investigated and responded to according to the provider's complaints policy but the outcome of the complaints was not always recorded.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 29 January 2019 and this is the first inspection

Why we inspected

This was a planned inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches of regulations in relation to safe recruitment of staff, safe care and treatment 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.