Galiant Health Care Almondsbury received a Good rating across all five key questions at its first inspection since registering in September 2018. The service demonstrated a strongly person-centred approach, safe care practices, and effective leadership promoting high-quality, flexible support to six people in their own homes.
Strengths
· People felt safe and staff demonstrated good knowledge of safeguarding procedures and reporting responsibilities.
· Sufficient staffing levels maintained without use of agency staff; shortfalls covered by regular team members.
· Medicines managed safely with trained staff, competency checks, and regular audits of medicines records.
· Highly personalised, flexible care planning with people and families actively involved in review and goal-setting.
· Strong person-centred culture embedded by registered manager, including involving people in staff recruitment.
Galiant Health Care Almondsbury improved from Requires Improvement to Good following a follow-up inspection on 20 January 2023, with Safe and Well-Led both rated Good. The provider remediated a prior breach of Regulation 17 by implementing effective monitoring and audit systems, and people reported positive experiences of safe, person-centred care.
Strengths
· People felt safe with staff and reported kind, caring relationships with carers.
· Risk assessments and care plans were in place to guide staff in providing safe support.
· Staff received specific training for complex needs, including PEG feeding.
· Medicine Administration Record (MAR) charts were completed and audited regularly.
· Sufficient staffing levels with adequate travel time between calls reported by staff and confirmed by service users.
Galiant Health Care Almondsbury was downgraded from Good to Requires Improvement after a focused inspection prompted by the registered manager's unexplained absence and lack of interim management arrangements. Inspectors found a breach of Regulation 17 (Good Governance) due to out-of-date audits, no analysis of incidents, and unresolved concerns about call timings, communication and missing in-home documentation.
Concerns (8)
criticalGovernance: “failed to ensure systems and processes were established and operated effectively to assess, monitor and improve the quality and safety of the service”
criticalLeadership: “The registered manager had been absent for some time. There was a lack of clarity as to who was carrying out their role.”
moderateMissed or late visits: “they sometimes arrive at 10am instead of 9am then they return within 2 hours for the lunchtime call, this means there isn't a four-hour gap for the medicines or for food”
moderateRecord keeping: “relatives we spoke with consistently told us a copy of peoples care plans and risk assessments were not kept in their homes”
moderateIncident learning: “Accidents and incidents had not been analysed... there was no detailed analysis to pick up and identify any trends or areas to prevent recurrence.”
moderateCommunication with families: “People and relatives told us they were not always happy with the standard of communication with the office based staff.”
moderateCare planning: “I have asked for a care plan 3 times, I have even emailed requesting the care plan and invoice, I still have not received these.”
minorMedication management: “one relative told us they were unsure if the medicine was administered at regular intervals as the time of administration was not recorded.”
Strengths
· Safe recruitment and selection processes including pre-employment checks were completed
· Staff had good insight and awareness of safeguarding procedures and how to report abuse
· Infection prevention and control policies and audits were effective in managing risk
· Staff were trained and confident in administering medicines safely
· Service worked closely with GPs, district nurses, social workers, occupational therapists and cancer nurses
Quality-Statement breakdown (10)
safe: Staffing and recruitmentNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Learning lessons when things go wrongNot rated
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Preventing and controlling infectionNot rated
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; Continuous learning and improving careNot rated
well-led: How the provider understands and acts on the duty of candour
Not rated
well-led: Engaging and involving people using the service, the public and staff; Promoting a positive cultureNot rated
well-led: Working in partnership with othersNot rated