Gill Care Services provides personal care for adults over 65years, people living with a dementia or people with physical disabilities living in their own homes. We assessed all quality statements under the five key questions of Safe, Effective, Caring, Responsive and Well Led. We undertook the assessment from the 17 to 26 September 2024. We visited the office on 17 September 2024. We identified some improvements since the last inspection. Staff knew how to act on safeguarding concerns and a system was in place. Risk assessments had been developed, but not all people’s individual risk in relation to conditions had been assessed. The registered manager and care coordinator took immediate action to address this. Staff had been recruited, training and supervision was undertaken. Action was taken to ensure medicines were managed safely. Care plans were in place and assessments had been undertaken. Evidence professionals involved in people’s care were seen. Consent for people’s care was in place and the provider confirmed a capacity assessment was completed for one person. Staff knew how to support people’s needs. They confirmed people received good care, were treated with dignity and respect. Up to date policies and guidance was in place and available to the staff team. Systems were in place to record and act on complaints. Surveys had been undertaken with people and staff and a regular newsletter was developed. The registered manager told us no one was in receipt of end of life care. However, we received feedback which confirmed the involvement of specialist support services. The provider gave assurances about this arrangement, and the evidence this was recorded. Staff were positive about working for Gill Care Services and felt supported and involved. Audits and an action plan had been developed to monitor the service. The registered manager confirmed they would ensure evidence to support the operation and oversight of the service was retained.
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Gill Care Services received an overall rating of Requires Improvement following inspections in November and December 2023, with breaches of regulation identified in safeguarding (Reg 13) and good governance (Reg 17). While care delivery, staffing and staff competence were rated Good, the provider failed to report a safeguarding concern, omitted statutory notifications, and had not submitted a Provider Information Return since 2021.
Concerns (7)
criticalSafeguarding: “The registered manager discussed an ongoing safeguarding issue which required reporting to the relevant authorities. However, this was not done until after day 1 of the inspection.”
criticalGovernance: “Not all statutory notifications in relation to some events had been submitted. The provider had also failed to submit their annual Provider Information Return since 2021.”
moderateCare planning: “Care records contained some evidence of individual risk assessments. However, not all people's individual risks had been assessed.”
moderateConsent / capacity: “A capacity assessment for 1 person where it was required was not completed until after day 1 of the inspection.”
moderateLeadership: “Some professionals told us that engagement with the management team was inconsistent and they did not always consistently acknowledge requests for information.”
minorIncident learning: “There was evidence of completed accident and incident records. However, the records would benefit from more detail to reduce any future risk and support monitoring.”
minorComplaints handling: “The complaints procedure in the service user guide was not always detailed, in line with the provider's policy.”
Strengths
· Staff had completed safeguarding training and knew how to report concerns
· Sufficient staffing levels with consistent staff allocated to the same people
· Safe recruitment processes with appropriate checks in place
· Medicines administration records completed and competency checks undertaken
· Infection prevention and control risk assessments and audits completed
Quality-Statement breakdown (20)
safe: Systems and processes to safeguard people from the risk of abuse and avoidable harmRequires improvement
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff working with other agencies; Supporting people to live healthier lives and access healthcareGood
caring: Ensuring people are well treated; respecting equality, dignity, privacy and independence; involvement in decisionsGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: End of life care and supportGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to maintain relationships and take part in activitiesGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Promoting a positive culture; understanding quality, performance, risks and regulatory requirementsRequires improvement
well-led: Working in partnership; duty of candourRequires improvement
well-led: Engaging and involving people, the public and staffGood
well-led: Continuous learning and improving careGood