Archived: Goldcrest Care Services

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.

• The service’s office is based in the Slough trading estate. Care is provided in the surrounding areas and into greater London areas.

• The service provides personal care to older adults, some of whom have dementia.

• This is the only location that the provider operates.

• At the time of our inspection, six people used the service and there were 11 staff.

People’s experience of using this service:

• The provider had made some improvements to the service since our last inspection. This meant the service had achieved compliance with the prior breaches of regulations.

• The governance of the service had not improved and therefore there is a breach of a regulation.

• The service had improved the amount of staff support. This included induction processes, supervision sessions, training and retraining and performance appraisals. Further improvements were needed to ensure that staff supervisions and appraisals were meaningful.

• Recruitment documentation had improved. The provider had ensured that more robust checks of new workers were completed, and obtained the appropriate documentation for personnel files.

• People were better protected against abuse and neglect. Systems and processes put into place where strengthened to ensure adults at risk were identified and safeguarded.

• People and relatives reported the service remained caring. Care was person-centred and planned and reviewed in conjunction with people and others.

• Insufficient processes are in place for the assessment of the safety and quality of care. More management oversight was required to ensure good governance of the service.

• The service’s ratings for each key question have not changed since our last inspection. The overall rating for the service remained at “requires improvement”.

• More information is in our full report.

Rating at last inspection:

• At our last inspection, the service was rated “requires improvement”. Our last report was published on 22 December 2017.

Why we inspected:

• All services rated “requires improvement” are re-inspected within one year of our prior inspection.

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

• The service is required to provide an action plan to us because there is a breach of a regulation.

• We made recommendations in our inspection report, which we will follow up at our next inspection.

• We will inspect the service again within one year of the publication date of this report.

Goldcrest Care Services Ltd is a small domiciliary care service based in Slough, which provides personal care to people in their own home. At the time of our inspection, four people used the service.

People were not always protected from abuse and neglect. Appropriate systems were not in place to safeguard people from the risk of preventable harm. Recruitment practices and supporting documentation did not meet the requirements set by the applicable legislation. We found appropriate numbers of staff were deployed to meet people’s needs. People’s medicines were safely managed.

The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People were assisted to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Staff induction, training, supervision and performance appraisals were lacking or insufficient and the service could not ensure workers had the necessary knowledge and skills to effectively support people. People’s care preferences, likes and dislikes were assessed, recorded and respected. We found there was collaborative working with other community healthcare professionals.

The service was caring. There was complimentary feedback from people who used the service. People told us they were able to participate in care planning and reviews and some decisions were made by staff in people’s best interests. People’s privacy and dignity was respected when care was provided to them.

Care plans were appropriate and contained information of how to support people in the right way. We saw there was an appropriate complaints system in place which included the ability for people to contact any office-based staff member or the management team. People and relatives told us they had no current concerns or complaints. Questionnaires were used to determine people’s satisfaction with the care.

Provider-level methods of good governance such as audits were not implemented at the service and therefore the quality and safety of the service could not be adequately measured. We made a recommendation about this. People told us that the management were friendly and approachable. They felt that the service was well-led.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and an offence under the Health and Social Care Act 2008.

You can see what action we told the provider to take at the back of the full version of our report.

Full information about our regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals are concluded.