Archived: Goldcrest Care Services

Updated 8 February 2022

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 Care Act 2014.

Inspection team

The inspection was carried out by an inspector and an Expert by Experience. An Expert by Experience (EXE) is a person who has personal experience of using or caring for someone who uses this type of care service. The EXE made telephone calls to people and their relatives.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service did not have a manager registered with the Care Quality Commission. This is a requirement to ensure they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

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 15 December 2021 and ended on 23 December 2021. We visited the office location on 15, 16 and 17 December 2021. The Expert by Experience made calls to people and relatives on 17 December 2021.

What we did before the inspection

The provider did not complete the required Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report.

We reviewed information we had received about the service since the last inspection and used this to plan and our inspection.

During the inspection

We spoke with eight people who used the service and three relatives about their experience of the care provided. We spoke with three care workers, a care supervisor, acting manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We sent 10 feedback request questionnaires to staff, of which one was completed and returned.

We reviewed a range of records. This included seven people’s care records, 11 recruitment records, staff training matrix and training records. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

We continued to seek further information and clarification from the provider to validate evidence found.

Updated 8 February 2022

About the service

Goldcrest Care Services is registered to provide personal care and support to people in their own homes. 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. At the time of the inspection the service provided care and support to 43 people.

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

Most people spoke positively about the caring nature of staff. However, some people felt the management of care call visits, was uncaring. A person told us, “It’s been annoying because they (management) just send anybody in and it’s making my anxiety worse.”

Peoples’ privacy and dignity was protected but this did not happen consistently. People told us they were able to maintain their independence.

People said they felt safe from abuse. Comments included, “Yes, safe enough” and “Yes, they don’t do any harm to her.”

People had not always received the level of support required to protect them from the risk of neglect. Staff demonstrated an understanding of how to identify and report abuse. Arrangements in place to assess and manage risks were not robust enough to keep people safe from harm. There were unsafe recruitment practices. The provider failed to ensure people received medicine support from staff who were assessed as competent to support them. The provider did not have robust systems in place to minimise the spread of Covid-19.

People received care from staff who were not appropriately trained and supported to fulfil the requirements of their role. Needs assessments did not take into account specific issues that are common in certain groups of people, document peoples’ food preferences and record and fully record peoples' nutritional and hydrational needs. We have made recommendations about this. The provider worked with health and social care professionals to ensure peoples’ health care could be met.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; as the policies and systems in the service did not support this practice. We found the service failed to act in accordance with the Mental Capacity Act 2005.

Some people felt the provider was not always responsive to their care and support needs. We have made a recommendation about this. The provider did not follow its complaints policy in regard to recording and investigating verbal complaints. We have made a recommendation about this. The service worked in accordance with the Accessible Information Standard (AIS), to ensure they met peoples’ communication needs.

Quality assurance systems and processes in place, did not enable the provider to identify where quality and/or safety was being compromised. This was seen when looking at various audits, monitoring and scheduling of care calls and how the provider responded to feedback. Staff did not follow Duty of Candour (DoC) policy to enable them to work in an open and transparent way. We have made a recommendation about this. There was no managerial oversight to ensure the provider could meet its regulatory responsibilities.

Rating at last inspection and update

The last rating for this service was requires improvement (published 28 January 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

The inspection was prompted in part due to concerns received about recruitment and staff training. A decision was made for us to inspect and examine those risks. We have found evidence that the provider needs to make improvements. Please see all the sections of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified multiple breaches in relation to need for consent, safe care and treatment, safeguarding service users from abuse and improper treatment, good governance, staffing, fit and proper persons employed and statement of purpose.

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.