GGW Care Limited

Updated 23 February 2024

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

This inspection was carried out by two inspectors on each site visit day and an Expert by Experience who made calls to people or their relatives over 2 days. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service

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 unannounced. Inspection activity started on 17 October 2023 and ended on 2 November 2023. We visited the location’s office on 17, 18 and 23 October 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authorities who work with the service.

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 visited the office and spoke with the registered manager and a care coordinator. We looked at 9 care plan records and 9 staff training and recruitment records as well as records related to the management and running of the service. The Expert by Experience and an inspector between them spoke with 7 service users, and 10 relatives of people using the service by phone following the office visits. The inspector also spoke with the deputy manager, a supervisor and 7 care workers by phone following the office visit. We asked for some information to be sent to us following the site visits for review.

Updated 23 February 2024

GGW Care Ltd is a domiciliary care service whose office is located in the London Borough of Croydon. The service currently operates in the London borough of Bromley and in Surrey offering mainly private packages of care to older adults, people living with physical disabilities, mental health needs and or dementia.

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 we were told the service supported 20 service users in Bromley and 5 in Surrey with personal care.

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

There was an absence of effective leadership and while some concerns identified in the warning notice we had served on the provider following the October 2022 inspection had been acted on other areas of concern we identified had not been resolved. We identified further areas of concern.

There remained an ineffective quality monitoring system. It was difficult to gather clear and consistent information and some records were not readily available, other records about people’s care were not accurate or contradictory. The registered manager did not have a clear grasp of the day to day running of the service.

Safeguarding issues were not always identified or managed effectively. Risks were not always assessed or safely managed. Medicines were not always safely managed. Staff recutiment processes were not sufficiently safe to ensure people were protected from unsuitable staff.

Assessments of people’s needs were carried out but they did not always accurately reflect their needs or the care provided. Care plans and assessment records we viewed contained contradictory information about the people staff supported. Staff did not always have guidance on how to provide person centred care. Care plans did not always guide staff on people’s individual preferences, likes and dislikes.

Care plan records did not show how people’ s needs under the Equality Act, such as their culture, religion or sexuality had been discussed or considered. Care plans did not guide staff on how to meet these needs.

People told us they felt safe and well looked after by staff. They said their calls were mostly on time and they were supported by staff who understood their health needs. Staff followed safe infection control practices.

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. However, we found some improvements needed to the way mental capacity assessments and best interests’ meetings were recorded to evidence that each decision was considered separately.

The provider had acted on our recommendation in relation to training and a new training provider had been sourced. Staff told us they received the right training for their roles.

People told us they were supported by staff who knew them well and who were kind and caring and supported them to be as independent as possible.

People and their relatives told us they knew how to raise a complaint and were confident these would be addressed and acted on.

People told us their views about the service were sought through surveys and regular phone calls. They had a strong relationship with their care coordinator or supervisor and contact with the service was mainly carried out this way rather than through the office.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service under the previous provider, at their previous address was requires improvement (published 3 February 2023). This service has been rated requires improvement for the last four previous inspections. The provider had completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

At our last inspection we recommended that the provider review their staffing levels and staff training arrangements. At this inspection we found the provider was using two new training providers. Staff told us they received appropriate training for their work.

Why we inspected

This inspection was prompted by a review of the information we held about this service and to follow up on action we told the provider to take at the last inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for GGW Care Limited on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to assessing risks, medicines management, safeguarding people from harm, safe recruitment processes, showing dignity and respect and providing person centred care, at this inspection.

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 in respect of some breaches identified. 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 next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.