Background to this inspection
Updated
25 March 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 1 inspector, and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was announced.
We gave the service 48 hours' notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 16, 17 February 2023 and ended on 23 February 2023. We visited the location's office on 16 and 17 February 2023
What we did before the inspection
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information we held about the provider and sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.
During the inspection
We spoke with 4 people who used the service and 7 people’s relatives about their experience of the care provided. We spoke to the business manager, nominated individual, and received feedback from 4 staff who delivered care to people. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records, this included 3 people's care records. We looked at staff files in relation to recruitment, training and a variety of records relating to the management of the service, including policies and procedures.
Updated
25 March 2023
About the service
Global Caring Gloucester is a domiciliary care service providing the regulated activity of personal care. At the time of our inspection there were 35 people using the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People's experience of using this service and what we found
Effective systems were not always being used to monitor the quality of people’s care, call times and the accuracy of record keeping. The provider’s systems and record keeping needed to be strengthened to assist them in monitoring the service and the quality of care.
The management of people’s risks were not always comprehensively recorded which placed people at risk of not receiving appropriate care and support.
We received mixed views from people and their relatives about the punctuality of staff and the duration of their care calls. A new system was being implemented to assist the provider and local authority to monitor people's care calls.
Staff did not always have access to guidance on how to support people to manage their medicines and reduce people's risks.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The provider used any feedback to help them drive improvements. Lessons were learnt and improvements were made when incidents occurred.
People and their relatives shared mixed views about the staff who supported them and the communication they received from the registered manager and staff.
Staff understood the importance of reporting any safeguarding concerns, incidents or changes in people's health and well-being. Safe infection control practices were used.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good. (published 29 June 2022).
Why we inspected
We received concerns in relation to the punctuality of staff and the management of people’s risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Global Caring Gloucester on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to the management of people's risk and prescribed medicines and the provider’s quality monitoring systems and record keeping.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspection.