Guardian Homecare (Basildon)

About the service

Guardian Homecare is a domiciliary care service providing personal care to people who live in their own houses and flats. At the time of our inspection, people were being supported by the service. 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.

The service also provides care and support to people living in a supported living setting, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at personal care and support. Support is primarily provided to people with learning disabilities and autistic people. People live in shared houses.

People's experience of using this service and what we found

The provider was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right Support

Staff did not always support people with their medicines in a way that promoted their independence.

People were supported to make decisions and staff communicated with people in ways that met their needs. Staff supported people to play an active role in maintaining their own health and wellbeing.

Right Care

Staff understood how to protect people from poor care and abuse and how to recognise and report any concerns.

Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture

The provider did not have effective systems in place to monitor the quality and safety of the service. For example, we found concerns with the provider's oversight of call times and medicines management.

Not all staff had felt valued and supported but this was improving following the involvement of the provider at the service.

People and those important to them, were involved in planning their care; however, we received some mixed feedback about how well the provider communicated with others.

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 March 2018).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support, right care and right culture.

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.

Enforcement and recommendations

We have identified breaches in relation to medicines management and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 inspect next.

Guardian Homecare (Basildon) provides a domiciliary care service for people living in their own homes. It provides a service to older and younger adults. The inspection took place on 13 February 2018 and was announced. This was to ensure that someone would be at the office to meet with us. At the time of our inspection 49 people were receiving personal care and support from the service.

There was a registered manager in post at the service. 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 and associated Regulations about how the service is run.

People told us they felt safe when receiving care and support and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm. Risk assessments had been completed so that staff knew how to keep people and themselves safe.

There were sufficient staff with the right knowledge and skills to meet people’s needs. Staff had been recruited safely. Staff had the competence and skills to administer medicines safely and as prescribed and there was a system in place to protect people from the risks of infection. The provider recorded, reviewed and investigated incidents and accidents and took the necessary action.

People’s needs were holistically assessed and support delivered in line with current guidelines. Staff were provided with training and supervision in order for them to carry out their role effectively. People’s health needs were met as staff liaised well with health and social care professionals. People were supported to be able to have their meals as and when they wanted them, which met their nutritional needs.

People had the maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service provided staff with clear guidance. Information about people’s end of life wishes were in the process of being improved.

People told us that staff were caring and kind and were respectful of them and their property. The service was responsive to people’s needs and wishes as they listened and involved them in their care. Positive relationships had been developed and were maintained. The service was meeting the Accessible Information Standard by ensuring people’s sensory and communication needs were met.

There was an effective complaints procedure in place and people and their relatives knew who to contact if they needed to. The provider regularly assessed and monitored the quality of the service provided. Feedback from people, their relatives and staff was encouraged with regular telephone contact and reviews and these were used to make improvements to the service.