Background to this inspection
Updated
12 February 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.
The office visit took place on 9 December 2015 and was announced. We told the provider we would be coming so they could ensure they would be available to speak with us and arrange for us to speak with care workers. The inspection was conducted by one 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. The inspector visited the office and spoke with five care staff and the registered manager, and looked at records. They also spoke with two staff by telephone the following day. The expert-by-experience spoke with six people, and four relatives of people who used the service, by telephone on 11 December 2015.
We reviewed the information we held about the service. We looked at the information received from our ‘Share Your Experience’ web forms and the statutory notifications the service had sent us. A statutory notification is information about important events which the provider is required to send to us by law. We also reviewed the information in the provider’s information return (PIR). This is a form we asked the provider to send to us before we visited. The PIR asked the provider to give some key information about the service, what the service does well and improvements they planned to make. We found the PIR reflected the service provided.
We also contacted the local authority commissioners for Coventry and Warwickshire to find out their views of the service provided. These are people who contract care and support services paid for by the local authority. Neither commissioner had current concerns about the provider, although one commissioner had concerns about the provider’s use of the call monitoring system until recently.
During our visit we spoke with four care workers and staff working in the office including the registered manager and the provider. We reviewed four people’s care plans to see how their care and support was planned and provided. We checked care workers had been recruited safely and were trained to deliver the care and support people required. We looked at other records related to people’s care and how the service operated including the service’s quality assurance audits and records of complaints.
Updated
12 February 2016
Gateway Health and Social Care is a care agency which provides personal care to people in their own homes. At the time of our visit the agency supported approximately 50 people with personal care.
We visited the offices of Gateway Health and Social Care on 9 December 2015. We told the provider before the visit we were coming so they could arrange for staff to be available to talk with us about the service. We also spoke with ten people who used the service, by telephone, on 11 December 2015.
At our last inspection in July 2014, the provider was in breach of one Regulation as they did not have assessments in place to determine people's mental capacity, and whether a best interest decision had to be made on their behalf. At this visit, there was no one being supported who did not have the capacity to understand and consent to the care being provided. This means the service is no longer in breach of the Regulation.
The service has a registered manager. 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.
There have been two safeguarding investigations at the service. Neither safeguarding concern was reported to the Care Quality Commission. This meant the provider was not following their legal requirement to notify us of these concerns.
There had been a number of changes to office staff since our last inspection. This meant there had been a lack of continuity in office management. The Coventry local authority commissioners were not satisfied the service had used their call monitoring system effectively so they could ensure all calls were undertaken when expected. However call monitoring had recently improved, and this demonstrated that calls were being carried out on time.
People told us they felt safe using the service and care workers understood how to protect people from abuse. Risks to people were assessed, and care plans were drawn up to inform staff of how to keep people safe. Background checks were carried out on care workers to ensure their suitability to work with people who used the service. There were enough suitably trained care workers to deliver care and support to people.
Most people had regular care workers who usually arrived on time and stayed the agreed length of time. People reported that staff were sometimes late but this was mostly at week-ends. The registered manager was actively recruiting new staff to provide additional cover for calls to give them greater flexibility to cover staff absence.
People told us care workers were kind and caring and had the right skills and experience to provide the care and support they required. They told us staff treated them with dignity and ensured their privacy during personal care.
The registered manager understood the principles of the Mental Capacity Act (MCA), and care workers respected people’s decisions and gained people’s consent before they provided personal care. People who required support had enough to eat and drink during the day.
Most people knew how to complain and knew who to contact if they had any concerns. Care workers were confident they could raise any concerns with the manager, knowing they would be listened to and it would be acted upon.