Date of assessment 16 April to 13 May 2024. Reason for assessment: We received concerns about the quality and safety of care which we wanted to check on. This was an unannounced assessment, which means the provider was not told an assessment was going to be starting beforehand. During this assessment we looked at 4 quality statements; Safe and effective staffing; medicines optimisation; Capable, compassionate, and inclusive leaders; and Governance, management and sustainability. We assessed some but not all quality statements at this visit which means we use the ratings from the previous inspection to rate the key questions of safe and well-led. We have not assessed any quality statements under effective, caring and responsive, so the rating judgement for this has not changed since our last inspection.
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G&C Healthcare Ltd was rated Requires Improvement overall at its first inspection, with breaches of Regulation 17 (Good Governance) and Regulation 19 (Fit and Proper Persons Employed) due to ineffective audits, unsafe recruitment practices, missing medicines protocols and late calls. Effective and caring domains were rated Good, with people reporting kind staff and involvement in their care planning.
Concerns (7)
criticalGovernance: “The providers audits were not always effective at identifying unsafe or poor practice.”
criticalStaff competency: “Recruitment practices were not robust enough to demonstrate a safe recruitment process.”
moderateMedication management: “protocols to support people to receive medicines as and when required were not in place and tis could lead to a person receiving medicine unsafely.”
moderateMissed or late visits: “calls were sometimes late... there were still a high number of late calls. This meant calls were still not being delivered at peoples preferred times.”
moderateCare planning: “one person was at risk of their skin integrity breaking down. There was no detail as to how staff should monitor this.”
minorRecord keeping: “Staff rotas did not detail visit times, so we could not verify whether calls were delivered at people's preferred times.”
minorCommunication with families: “Most people we spoke with commented how staff were a little hard to understand due to cultural differences”
Strengths
· Staff had access to and appropriately used personal protective equipment (PPE)
· Staff felt well supported, well trained and listened to by the registered manager
· People, and their relatives, were involved in needs assessments and care plan development
· Registered manager was open, transparent and acted on duty of candour
· Staff had good understanding of safeguarding and how to report concerns
Quality-Statement breakdown (25)
safe: Staffing and recruitmentRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices, delivering care in line with standards, guidance and the lawGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff support, induction, training, skills and experienceGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
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 control and to meet their needs and preferencesRequires improvement
responsive: Meeting people's communication needsRequires improvement
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
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
well-led: Continuous learning and improving careGood