GND Support, a small domiciliary care agency in Milton Keynes, was rated Requires Improvement overall on its first inspection, with Safe and Well-Led key questions falling short due to incomplete risk assessments and gaps in governance and audit systems. Effective, Caring and Responsive were all rated Good, with people reporting high satisfaction with staff and management.
Concerns (6)
moderate
Care planning
: “risk assessments did not cover all potential risks such as managing distressed behaviour or falls.”
moderateGovernance: “the safety issues we identified such as the lack of a detailed risk assessment for falls and behaviours that challenged had not been identified through the auditing system.”
moderateRecord keeping: “One notification regarding a person who received hospital treatment had not been submitted to CQC. The registered manager apologised for this oversight.”
minorSupervision / appraisal: “Some issues had been raised in the surveys though there was no action plan to address these.”
minorStaff competency: “references were not always from the management of previous employers to fully ascertain whether people were competent.”
minorComplaints handling: “the procedure implied that the Care Quality Commission investigate complaints. This is not the case as CQC cannot, by law, investigate individual complaints.”
Strengths
· People reported feeling safe and said staff protected them from abuse, neglect and discrimination.
· Sufficient staffing was always in place with no missed calls reported.
· Staff wore appropriate PPE and had received infection control training including COVID-19.
· People were treated with dignity and respect; staff encouraged independence and privacy.
· People were involved in planning their own care and their preferences were reflected in care plans.
Quality-Statement breakdown (24)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidance (MCA)Good
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Continuous learning and improving careRequires improvement
well-led: How the provider understands and acts on the duty of candourRequires improvement
well-led: Engaging and involving people using the service, the public and staffRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Managers and staff being clear about their roles and understanding quality performance, risks and regulatory requirementsGood
GND Support, a small supported living service for 2 people with mental health needs in Milton Keynes, improved from Requires Improvement to Good following its June 2023 inspection of the Safe and Well-Led domains. The service demonstrated safe recruitment, effective medicines management, robust quality audits and a positive person-centred culture under an accessible registered manager.
Strengths
· People felt safely supported and told us their needs were met; staff recruited safely with DBS, ID and reference checks
· Medicines administered safely, stored securely and documentation accurately completed by competent staff
· Risk assessments in place, regularly reviewed and updated, covering medical conditions, mobility and distressed behaviours
· Effective infection prevention and control with staff trained and provided with appropriate PPE
· Comprehensive audit and quality monitoring systems in place including monthly medicine administration and incident analysis
Quality-Statement breakdown (11)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
well-led: Continuous learning and improving careGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood