Golden Key Support Ltd retained an overall Good rating at this focused inspection, with Safe downgraded to Requires Improvement due to outdated risk management plans, inaccurate timesheet recording and lapses in COVID-19 testing. Effective and Well-led remained Good, supported by trained staff, consistent care workers and effective family engagement, though recommendations were made regarding mental capacity assessments.
Concerns (7)
moderateCare planning: “Risk management plans were not always updated when people's needs had changed.”
moderateRecord keeping: “We could not be assured that the times recorded on timesheets accurately reflected the time people received support.”
moderateConsent / capacity: “Aspects of how the provider obtained consent did not fully reflect best practice... Sometimes mental capacity assessments were not clear on exactly what the specific decision being assessed was.”
moderateGovernance: “Service development was not always effectively planned... this plan was broad in places, and lacked clear details on what exactly would be done with timescales and clear responsibilities.”
minorMedication management: “Sometimes prompting and administering were used interchangeably in people's care plans, which meant plans did not fully describe people's support needs consistently.”
minorInfection control: “The provider had not been following testing requirements for COVID-19... the provider was not aware of this requirement and had stopped routine testing of care staff.”
minorRecord keeping: “Care workers did not consistently record the support people received with eating and drinking... they did not always record what they had supported a person to eat or drink.”
Strengths
· People received care from consistent care workers who arrived on time and met their needs.
· Suitable safeguarding systems and trained staff who understood their responsibilities to report abuse.
· Safe recruitment processes including DBS checks, references and full work history.
· Staff received the right training, induction, supervision every three months and competency observations.
· Effective engagement with people and families including monthly contact and spot checks.
Quality-Statement breakdown (14)
safe: Systems and processes to safeguard people from the risk from abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies; supporting people to access healthcareNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Duty of candour and continuous learning and improving careNot rated
well-led: Managers and staff being clear about their roles; working in partnership with othersNot rated