GN Care Services Ltd

GN Care Services Ltd is a domiciliary care agency providing personal care. The service provides support to people living in their own homes in the community. At the time of our inspection there were 30 people using the service. 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

Some aspects of the recruitment process were not always safe. Some staff files did not contain all the information providers are required to have to ensure staff are of good character and suitable to work with people. After the inspection the provider sent us confirmation on how they would reduce risk in this area and keep people safe.

After our last inspection the provider sent in an action plan to tell us how they were going to make improvements in the systems to help monitor missed and late calls. At this inspection we found the provider had started to introduce a new monitoring system. They hoped to fully implement this system by the end of November 2022. The provider had also introduced new quality assurance checks to make sure people received care and support in line with our regulations. Unfortunately, the checks did not identify the issues we found with recruitment. This meant there was still a risk that the provider may miss areas of risk and unsafe practice.

The provider had systems and processes in place to safeguard people from abuse. Staff knew how to protect people from abuse and how to manage people’s risk to keep people safe. People’s medicines were managed safely. There were enough staff to support people and meet their needs. Staff followed infection and prevention procedures to help reduce the risk of infection. 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 in the process of making improvements to the service and continued to work with the local authority to make things better for people. The provider engaged and involved people and staff in the running of the service and made sure they used learning from concerns raised to develop their systems and processes to improve the care and support people received.

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 requires improvement (published 20 September 2022).

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 the provider was making improvements in the areas identified in their action plan but remained in breach of regulations.

Why we inspected

We undertook a targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted by concerns received about the recruitment procedures in place having an impact on people’s safety. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern with some checks carried out to make sure the recruitment of staff was safe, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.

Enforcement

We have identified breaches in relation to checks undertaken as part of the recruitment process and how the provider assesses and manages risk in relation to recruitment.

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.

GN Care Services Ltd is a domiciliary care agency providing personal care. The service provides support to people living in their own homes in the community. At the time of our inspection there were 30 people using the service. 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

The provider could not be fully assured people received their care and support at the times agreed with them. There were no systems in place to audit the accuracy of records maintained about care calls. This meant the provider could not fully assure themselves staff were attending care calls at the right time and for the duration planned. This increased the risk of people not receiving the care and support planned for them and at the times agreed. The provider was taking action to improve this. However, we were not fully assured the provider had effective oversight and governance processes in place to reduce the risk of people receiving unsafe, poor quality care.

Not all the people using the service received consistent care and support from regular staff which increased the risk of them receiving poor quality care from staff who did not know them and unfamiliar with their needs.

Notwithstanding the issues above, people were safe using the service. Staff knew how to safeguard people from abuse and what action to take, to report concerns to the appropriate authority. Staff knew how to manage risks to people, to keep them safe. There were adequate numbers of staff to support people and meet their needs. Staff followed current practice when providing personal care which reduced infection and hygiene risks in people’s homes.

People were reasonably satisfied with the care and support they received from staff. They told us the service was good when they received support from regular staff that came on time. People were involved in planning their care and support and could state their preferences for how this was provided.

Where the service was responsible for this, staff helped people to eat and drink enough to meet their needs and take their prescribed medicines. Staff understood people’s healthcare needs and how they should be supported with these. They reported concerns they had about people’s health and wellbeing so that appropriate support could be sought for them.

Staff received training to help them meet people’s needs. Staff were supported and encouraged to continually learn, develop and improve in their role. The provider carried out spot checks on staff to make sure they were carrying out their duties appropriately and to a high standard.

Staff were caring and treated people well and respected their right to privacy, dignity and independence. 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 regularly monitored the safety and quality of care and support provided to people. They checked with people at regular intervals that the care and support provided was meeting their needs and sought their views about how the service could improve. There were arrangements in place to investigate accidents, incidents and complaints and people to be involved and informed of the outcome.

The provider was taking action to improve the service. The provider was working with a local authority to address concerns they had about care calls and the quality of service provided, to improve the service for people. The provider had a plan in place to make improvements and were starting to see some positive outcomes from their actions. They had also used the learning from concerns to improve and update their systems and processes to improve the care and support provided to people.

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

Rating at last inspection

The last rating for this service was requires improvement (published 2 April 2021).

At our last inspection we recommended that the provider review their recruitment process and systems to ensure they obtain all of the information required by law before any new staff start work. At this inspection we found the provider had acted to improve their recruitment process and systems.

Why we inspected

The inspection was prompted in part due to concerns received about missed care calls, the timeliness of care calls and quality concerns about the care and support provided by the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the caring 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 a breach in relation to good governance. 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.

GN Care Services is a domiciliary care agency providing personal care to 15 people in their own homes and in the local community at the time of the inspection.

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

People felt safe receiving care and support from staff, but some staff files did not contain all the information providers are required to have to ensure staff are of good character and suitable to work with people.

We have made a recommendation to the provider about improving their recruitment processes so they can ensure this is always complete for new staff.

We were assured the provider was following national infection prevention and control guidance to protect people from the risk of COVID-19 and other infections. This included appropriate use of PPE, social distancing and COVID-19 testing.

People had individual risk assessments that were detailed so staff knew how to care for them safely. People and relatives were happy with the way staff managed risks. Some staff had not received all of the training they needed to care for people safely in emergency situations. The provider was taking action to address this and there were systems in place to ensure the provider took appropriate action if things did go wrong. People received their medicines as prescribed. Staff knew how to handle people’s medicines safely and the provider was in the process of improving their records so it was clearer which medicines people needed to take. Staff understood how to safeguard people from abuse and neglect and how to report any concerns.

Most people were happy with the reliability and timekeeping of staff. There were systems to ensure there were enough staff available at all times to attend planned visits on time, take the time they needed to spend with people and cover any absence.

People and relatives were happy with the service they received. We received positive feedback from people, relatives and staff about the open culture and supportive approach of the service and registered manager. Relatives told us the provider was open and honest with them if things went wrong.

Staff and managers were clear about their roles and worked well together as a team. There was good communication between all levels of staff and with people and their relatives. The service sought feedback regularly from people, staff and relatives and used this to continually improve the service. There were suitable checks and tools in place for the provider to ensure they were complying with regulations and to assure service quality. Although some aspects of the service needed improvement, the provider was aware of this, understood their responsibilities and had plans in place to make the improvements.

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 23 July 2019 and this is the first inspection.

Why we inspected

We received concerns in relation to recruitment and the suitability of staff. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. We found no evidence during this inspection that people were at risk of harm from this concern, although we have found evidence that the provider needs to make improvements. Please see the safe section of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.