Goldleaf Homecare

Updated 28 March 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This comprehensive inspection was carried out by one inspector.

Service and service type: City Care Welwyn is a home care agency. It provides personal care to older people living in their own homes who may be living with dementia, have a learning disability, and/or a physically disability.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 7 March 2019 and ended on 12 March 2019. We visited the office location on 7 March 2019 to see the manager and office staff; and to review care records and policies and procedures.

What we did:

Prior to the inspection we reviewed information we held about the service, for example, notifications we received from the service and information shared with us from members of the public. A notification is information about important events which the service is required to send us by law.

During the inspection we spoke with the human resources manager, training manager, quality assurance officer, deputy manager and the registered manager. We looked at five care plans, five staff files, the complaints folder, quality assurance records and other records relating to the management of the service.

After the inspection we contacted seven people, one relative, two staff members and two healthcare professionals to gather their views of the service. We did not receive a response from either healthcare professional.

Updated 28 March 2019

About the service: City Care Welwyn Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of the inspection, the service was providing personal care to 52 people.

People’s experience of using this service:

¿ At the last inspection on 30 June 2016 we identified people had not signed to give consent to care and treatment, risks associated with the support people received were identified by staff and effectively mitigated, however these were not evidenced in people`s plan of care; and audits had not been always as effective. At this inspection on 7 and 8 March 2019 we identified the registered manager had made improvements to all areas and we were satisfied with their response.

¿ People continued to be safe as risk management plans identified known risks and gave staff clear guidance on how to mitigate those risks. Staff had sufficient understanding of how to identify, respond to and escalate suspected abuse. Staff received on-going safeguarding training.

¿ People’s medicines were managed safely and administered as intended by the prescribing Pharmacist. Medicines were regularly audited to ensure any errors were identified quickly and action taken to minimise the negative impact on people.

¿ The registered manager deployed sufficient numbers of suitable staff to keep people safe. Staffing levels were adequate and people confirmed staff had sufficient time to sit and talk with them.

¿ People continued to be supported by staff that received regular training to enhance their skills and experience. Through regular supervisions and spot checks, staff reflected on their working practices.

¿ Staff were knowledgeable about and adhered to the principles of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. People’s consent to care and treatment was sought, documented and respected.

¿ People were supported to access food and drink that met their dietary needs and preferences where agreed in their care package. Where there were concerns about people’s health and well-being referrals were made to healthcare professionals and advice given implemented into the delivery of care.

¿ People continued to be supported by staff that encouraged their independence, treated them equally and with kindness and compassion. People’s dependency levels were regularly reviewed and support provided to reflect people’s current needs.

¿ Care plans were person centred and gave staff clear guidance on the support people required in line with their wishes and preferences. Care plans were reviewed regularly and where possible people and their relatives were encouraged to develop these.

¿ People were able to raise concerns and complaints and there were systems and processes in place to ensure complaints were managed responsively and in a timely manner.

¿ People, their relatives and staff spoke positively about the registered manager. People and staff confirmed the management structure at the service was effective. People’s views were regularly sought to drive improvements. An external organisation carried out a comprehensive quality monitoring process, to gather people’s views. Issues identified were acted on in a timely manner.

¿ The registered manager carried out regular audits of the service to monitor the service provision. Issues identified during the audits were acted on swiftly and lessons learnt to minimise the risk of repeat incidents.

¿ The registered manager continued to encourage partnership working with other stakeholders and healthcare professionals.

Rating at last inspection: The service was previously inspected on 30 June 2016 and was given an overall rating of Good. We gave the service a rating of Requires Improvement in the key question, is the service well-led?

Why we inspected: This was a planned inspection in line with our inspection programme.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received, we may inspect the service sooner.