Gill Care Services

Gill Care Services is a domiciliary care service providing personal care to people living with a dementia, older people or physical disability living in their own homes. At the time of the inspection 14 people were in receipt of care from the service.

People’s experience of the service and what we found

Staff had undertaken safeguarding training. However, the provider had failed to inform relevant authorities of a safeguarding concern. Individual risk assessments had not always been completed. Incident and accident records had been completed but would benefit from more details. There were no concerns found in relation to staffing and recruitment.

People were somewhat 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. A capacity assessment for 1 person where it was required was not completed until after day 1 of the inspection. Staff had completed training and supervision and competency checks had been completed. Care plans included information about people’s needs and preferences. Assessments of people’s needs had been completed and relatives told us they were informed of changes in people’s healthcare conditions.

People received good care and their individual needs were met. Feedback from relatives was positive about the care staff provided. Care records contained good information to support staff in providing people’s care. People were supported with activities if this was part of their care plan. People’s alternative ways of communicating were considered. The complaints procedure in the service user guide was not always detailed, in line with the provider’s policy.

Audits and monitoring were taking place. However, the provider was not consistently providing information in line with their regulatory responsibilities, and it was sometimes difficult to engage with the provider. The registered manager sought feedback from people and staff had the opportunity to discuss their experiences at team meetings. A range of policies were in place however, the service was not consistently making use of records and guidance in them to support the operation and oversight of the service.

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

Rating at last inspection and update

The last rating for this service was good, published on 17 October 2019. Further focused inspections were published on 21 May 2021 and 30 September 2020. No changes to the overall rating were made at these inspections.

Why we inspected

This inspection was prompted by a review of the information we held about this service and to review ratings from the last inspections.

Enforcement and Recommendations

We have identified breaches in relation to safeguarding service users from abuse and improper treatment and good governance.

We have also made recommendations in relation to ensuring the provider seeks nationally recognised guidance, to ensure systems are in place to assess risks and to ensure all people, where it was required were assessed in relation to their capacity to make decisions and choices. 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.

Gill Care Services is a domiciliary care agency providing personal care to people in their own homes.

Not everyone who used the service received personal care. The Care Quality Commission (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. At the time of the inspection, 15 people were receiving care and support.

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

During this inspection, we looked at the processes used to recruit staff. We found improvements had been made and action had been taken to address the shortfalls noted at the last inspection. Staff were recruited safely. We discussed making start of employment dates clearer and ensuring any undated references were dated.

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

Rating at last inspection and update

The last rating for this service was good (published 17 October 2019).

Why we inspected

On 30 September 2020, we carried out an announced targeted inspection of this service to follow up on concerns raised about recruitment. A breach of legal requirements was found in relation to unsafe recruitment practices. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this targeted inspection to check they had followed their action plan and to confirm they now met legal requirements. The overall rating for the service has not changed following this targeted inspection and remains good.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

This report only covers our findings in relation to the Key Question safe, which contain those requirements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gill Care Services on our website at www.cqc.org.uk.

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.

Gill Care Services is a domiciliary care agency providing personal care to people in their own homes. 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. At the time of inspection, 12 people were receiving regulated activity.

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

During the inspection, we had concerns about the recruitment processes for all of the staff members' files we considered. In two of the seven files, the concerns were at a level where the registered manager said they would suspend the members of staff preventing them from working with people. This was so that further investigations could take place to ensure people were safe. In other cases, the registered manager undertook to complete enquiries such as speaking to previous employers in health and social care and establishing staff members' full work history. As a result of these concerns, the provider is in breach of the regulations. Details of this can be seen in the 'Safe' section of this report.

Rating at last inspection

The last rating for this service was Good (published 17 October 2019).

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in response to concerns received about safe recruitment of staff. A decision was made for us to inspect and examine those risks.

At the previous inspection, we made a recommendation the provider improve its recruitment processes to ensure people were safe.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question. We found no evidence during this inspection that people were at risk of harm from these concerns.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Gill Care Services 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 identified one breach in relation to the recruitment of new staff.

Please see the action we have told the provider to take at the end of this 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.

Gill Care Services is a domiciliary care agency providing personal care to people in their own homes. 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. At the time of inspection, two people were receiving regulated activity.

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

There were issues around the safe recruitment of staff. Some pre-recruitment checks were not made in the four files we considered and, in one case, the service could not be satisfied that a member of staff had been safely employed. After the inspection, additional checks were made to support that the person was safe to work with vulnerable people. We found no evidence people were at risk of harm from this concern. This has resulted in making a recommendation that can be seen in the 'safe' section of this report.

People told us they felt safe. Staff understood their responsibilities about keeping people safe. Risks were identified and managed. Incidents and accidents were recorded so that they could be considered and reflected upon to make improvements to the service. Staff understood their responsibilities to prevent the spread of infection whilst working in and between people's homes.

People told us staff were kind and caring. People said staff, including the registered manager, had met their expectations of a care service. People and relatives had a high levels of trust in staff which had a positive impact on their wellbeing. People and relatives described staff as "really good and caring". Staff supported people to remain independent and promoted their dignity. People's privacy was respected and their personal information was kept confidentially.

At the time of the inspection, the service was not administering medicines. There was a comprehensive medicines policy around the management of medicines and staff had been trained in this area.

Staff had completed training in key areas and were supported to carry out their roles. People and relatives had confidence in staff and were content with the care they received. People were supported to access health services if needed. People's dietary needs were assessed and, where required, they were supported with their meals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's care plans were up to date about their individual needs and preferences. People received support that met their needs. People and their relatives knew how to complain, although none we spoke with had any complaints.

The service was managed by a registered manager who had a clear vision about the quality of care they wanted to provide. Staff were aware of their roles and responsibilities. There were quality assurance systems in place to monitor the quality and safety of the service. There was a focus on continuous improvement.

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 13/02/2019 and this is the first inspection.

Why we inspected

The inspection was prompted, in part, due to concerns received about the service's handling of concerns raised by the local authority. A decision was made for us to inspect and examine those concerns. Planning was also based on the date the agency first registered with CQC.

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.