Grande Care Ltd

Updated 1 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 3 inspectors. 2 inspectors visited the location’s office and 1 inspector spoke with staff and people over the telephone.

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 24 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 the 31 January 2023 and ended on 9 February 2023. We visited the location's office on the 31 January 2023.

What we did before the inspection

We reviewed information we held about the service since the last inspection and sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 members of staff including the registered manager and care staff. We also received feedback from 2 care staff by email. We gathered feedback from 3 relatives and 1 person about their experiences of care. We reviewed 3 people’s care plans including their medicine administration records and a variety of records relating to the management of the service. This included recruitment files, a training matrix, policies, procedures, complaints, safeguarding concerns and spot checks.

Updated 1 March 2023

About the service

Grande Care Limited is a domiciliary care service providing personal care to people in their own homes. The service provides support to people with complex needs, older people, and those with mental health needs, dementia and physical disabilities. At the time of our inspection there were 8 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

The management of medicines required improvement. Risks were not always assessed which put people at risk of receiving unsafe care. Governance systems and processes did not provide an effective means of identifying where improvements were needed, to ensure the service was safe and met regulatory requirements.

Staff understood how to manage risks to people’s health and safety. People and their relatives told us they felt safe with the care they received. The registered manager understood their legal responsibilities to protect people and share important information with the local authority and CQC. People received care and support from a consistent staff team who had time to get to know their individual needs and preferences and staff were recruited safely. Staff received training in infection prevention and control and were provided with Personal Protective Equipment (PPE).

The provider assessed people’s needs and choices before they began using the service. The provider's induction and training provided staff with the skills and competencies needed to carry out their roles effectively. People were supported to access other health professionals as required. Staff followed advice and guidance provided by health professionals to meet people’s nutritional needs.

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.

We received positive feedback from people, their relatives and staff about Grande Care. The registered manager had a clear vision and ethos for the service which was to provide people with a small staff team they could build confidence with and develop trusted relationships. People were given the opportunity to provide feedback on care through regular home visits carried out by the registered manager. Important events and incidents were reported to CQC as per regulatory requirements. The registered manager worked in partnership with other health and social care professionals to ensure positive outcomes for people.

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 15 August 2018).

Why we inspected

We received concerns from the local authority's safeguarding team regarding the quality of personal care people received to maintain their personal hygiene. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only to examine those risks. We found no evidence to support these concerns, but we have found evidence that the provider needs to make improvements in other areas of care. Please see the safe and well led sections of this full report.

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.

Enforcement

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.