Goldcrest Healthcare Service (London)

Goldcrest Healthcare Services Limited is a domiciliary care service providing personal care and support for people in their own homes. At the time of the inspection the service provided support for 15 people. 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 provider had made improvement to the assessment and management of risks to ensure staff were provided with appropriate guidance to reduce possible risks when providing support. The provider had also made changes to their quality assurance systems which enabled them to monitor the care provided and make changes when identified to improve the service.

There was a robust recruitment procedure which meant the provider could ensure new staff had the appropriate skills and knowledge for their role. People received their medicines as prescribed and in a safe manner. When an incident and accident occurred it was recorded and any lessons which could be learned were identified to reduce possible further risk. Staff completed infection control training.

People received care which was person-centred. Relatives felt their family member received care which was safe. People were supported to provide feedback on the quality of the care their received. Staff felt they were support by the management of the service.

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 was requires improvement (published 6 May 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 14 February 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe, care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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 requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Goldcrest Healthcare Service (London) on our website at www.cqc.org.uk.

Follow up

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

Goldcrest Healthcare Services Limited is a domiciliary care service providing personal care and support for people in their own homes. At the time of the inspection the service provided support for 27 people. 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 provider had made some improvement in relation to the management of risk since our last inspection in May 2021, but further action was required to ensure care workers were provided with appropriate information to mitigate possible risks.

Some improvements had been made to the quality assurance procedures, but the provider needed to review their monitoring systems in relation to the management of risk.

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.

People told us they felt safe when care workers supported them. The provider had made improvements to the management of people’s medicines. There was a robust recruitment procedure and care workers were appropriately deployed to ensure visits happened as planned. The provider had made improvements in the recording and investigation following an incident.

Care workers completed training identified by the provider as mandatory and received supervision from senior staff which ensured they had the knowledge and skills to provide care in a safe and effective way. An assessment of a person’s support needs was completed before the care visits started. People and relatives were happy with the care they received, and they felt the care workers who visited them were kind and caring.

The provider had made improvements in relation to the care plans to ensure they described the care and support the person required and how they wanted it to be provided. The provider had a complaints procedure and complaints were responded to in a timely manner. People told us they knew what to do if they wished to raise any concerns.

People using the service, relatives and care workers felt the service was well-led. Care workers felt they were supported in their role. The provider worked in partnership with a range of organisations.

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 was requires improvement with the rating of inadequate for the key question of well Led (published 23 July 2021) and there were breaches of regulation. We issued Warning Notices to the provider in relation to safe care and treatment and good governance requiring them to comply with the regulation by 20 August 2021.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made but the provider was still in breach of regulation in relation to safe care and treatment and good governance.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. 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 Goldcrest Healthcare Services Limited on our website at www.cqc.org.uk.

Enforcement and Recommendations

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 monitor the service and will take further action if needed.

We have identified breaches in relation to management of risk 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 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.

Goldcrest Healthcare Services Limited is a domiciliary care service providing personal care and support for people in their own homes. At the time of the inspection the service provided support for 44 people. 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 provider did not always have risk management plans to provide care workers with appropriate guidance to manage identified risks.

There was a process for the administration of medicines but the provider did not always ensure this process was followed, so that information was provided and recorded to ensure medicines were administered as intended.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People’s care records did not always provide accurate information relating to the care and support they needed, so staff did not always have all the information they needed to care for people. People’s wishes in relation to how they would like their end of life care provided were not recorded.

Audits were carried out to check the quality of the service, but these did not always identify where improvements were needed. People told us they felt safe when they were supported by care workers in their own home. The provider had a recruitment process to ensure care workers had the appropriate skills and knowledge to provide care in a safe manner. Effective infection control processes were in place.

An assessment of a person’s support needs was carried out before any care package started. Staff felt they were supported by their manager. Care workers completed a range of training and had regular supervision.

People told us the care workers that visited them were kind, caring and respected their privacy and dignity. Care plans identified people’s religious and cultural wishes and how to support the person so their needs were met.

People’s communication needs were identified in their care plans. There was a complaints process in place and people told us they knew what to do if they wished to raise any concerns.

The provider worked in partnership with other organisations. People using the service and care workers felt the service was well led.

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 was requires improvement (published 31 October 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations. The service remains requires improvement.

Why we inspected

This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well led sections of this full report. You can see what action we have asked the provider to take at the end 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 breaches in relation to safe care and treatment, need for consent, person centred care and good governance 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. We will work alongside the provider and 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.

Goldcrest Healthcare Services Limited is a domiciliary care service providing personal care and support for people in their own homes. At the time of the inspection the service provided support for six people whose care was funded by a local authority and three people who funded their care through direct payments. 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

We saw the provider had risk assessments and risk management plans. However, where a specific need, such as a healthcare condition, had been identified, a risk management plan had not been developed to provide care workers with appropriate information to enable them to reduce the risks associated with the medical condition.

There was a process for the administration of medicines, but records did not always indicate how the person should be supported to take their medicines.

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; the policies and systems in the service did not support this practice.

People’s care records did not always provide accurate information relating to the care and support they needed, so staff did not always have all the information they needed to care for people.

The provider had a range of audits in place, but the audit in relation to care plans did not provide appropriate information to identify where actions for improvement were required.

People told us they felt safe when they received care in their home. The provider had appropriate recruitment processes in place so only suitable staff were employed to care for people.

Detailed assessments of a person’s needs were completed before they started to receive visits. Staff were appropriately supported in their roles. They completed a range of training and had regular supervision with their manager.

People felt the care workers were kind and caring. They also felt their dignity and privacy was respected when receiving care. The care plans identified each person’s religious and cultural needs and how care workers could provide support to meet these needs.

The provider had a complaints process in place and people told us they knew what to do if they wished to raise any concerns.

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

Rating at last inspection

This service was registered with us on 10/10/2018 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date the service started operating. We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches of regulations in relation to the management of medicines, managing risk, mental capacity, person centred care and quality assurance 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 work alongside the provider and 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.