Gardiner's

Updated 26 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 27 and 30 November 2017. This was a comprehensive announced inspection. The provider was given 48hrs notice because the location provides a domiciliary care service and we needed to be sure that senior staff would be available in the office to assist with the inspection. The inspection was completed by one inspector over both days.

Prior to the inspection the local authority care commissioners were contacted to obtain feedback from them in relation to the service. The service is predominantly provided to privately funded people therefore we received minimal feedback. We referred to previous inspection reports, local authority reports and notifications. Notifications are sent to the Care Quality Commission by the provider to advise us of any significant events related to the service. As part of the inspection process we also looked at the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We had received the PIR for Gardiner’s and used this to help inform our inspection plan.

During the inspection we spoke with six members of staff, including one care support worker, three care managers, the registered manager and the nominated individual. We further sent out surveys to three care staff. We spoke with eight people who are supported by the DCA staff.

Care Plans, health records and additional documentation relevant to support mechanisms were seen for nine people. In addition a sample of records relating to the management of the service, for example staff records, complaints, quality assurance assessments and audits were viewed. Staff recruitment and supervision records for 11 of the regular staff team were looked at.

Updated 26 April 2018

This inspection took place on 27 and 30 November 2017. This was an announced inspection as Gardiner’s is a Domiciliary Care Agency (DCA) and we needed to be sure someone would be at the office. A DCA is a provision that offers specific hours of care and support to a person in their own home.

At the time of the inspection a registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was rated at the previous inspection of September 2015 as safe and remained safe. Sufficient staff were employed to manage people’s needs, and enable them to engage in activities of their choice, through appropriate risk management. Staff knew how to safeguard people from abuse and were aware of the protocols to follow should they have concerns. Staff reported that they would not hesitate to whistle-blow if the need arose. Where staff were involved in medicine management this was managed safely. Staff were competency checked annually and audits were completed monthly to ensure people were supported by staff with the necessary skills to keep them safe.

The service remained effective. Support was delivered by a highly trained staff team, who were able to respond appropriately to people’s changing needs. Staff were supervised and supported by an effective management team, who made certain they were available to staff at all times. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

The service remained caring. Staff were reported to be polite, respectful and ensured they maintained people’s dignity when supporting them. They encouraged open communication and worked on motivating people to increase their independence. Evidence of using systems of communication that reflected the person’s choice highlighted that staff communicated with people in the way they wished.

The service remained responsive. Care plans were individualised, focusing on people’s specific needs. The service took necessary action to prevent and minimise the potential of social isolation. Activities were arranged and co-ordinated by the service to increase community engagement, and increase well-being. People reported having accessed the community after considerable length of time of not doing so. This reportedly made them feel a sense of belonging. People and staff were protected from discrimination. The service understood the importance of ensuring Equality Diversity and Human Rights (EDHR) was met, and that people’s protected characteristics were not discriminated against. Measures were in place to allow people to be treated equally, with systems continually being reviewed to ensure exemplary practice was maintained. Systems to monitor and investigate complaints were in place.

The service had developed exceptional methods of good governance that provided real time evaluation of practice. A thorough quality assurance audit was completed annually with an action plan being generated, and followed upon. Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service. We found evidence of compliments and complaints that illustrated transparency in management. Staff spoke highly of the registered manager’s skills and how these were shared with staff to continually help them grow and achieve good practice. The service focused on developing relationships with the community and with relatives of people, so to ensure good practice was maintained for the person continually. The service was considering offering family carers the opportunity to attend training that would enable them to have an insight into their loved one’s lives and how they saw the world. The service developed systems to help people achieve a fulfilling life. The service was well-led and focused on staff having ownership of the service.