Gentle Healthcare Services

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Based on the findings of this assessment we found the service had improved and addressed all the outstanding breaches we identified at their last inspection. This meant people were now kept safe and protected from avoidable harm. This was because the provider had implemented the action plan we required them to complete after their last inspection and improved how they assessed and managed risk, and recruited and supported staff. In addition, the provider continued to have a positive culture of learning lessons when things went wrong. Care plans were still based on pre-assessments conducted by the provider and various external health and social care professionals prior to people receiving a service. People continued to receive continuity of care from a dedicated group of staff who were familiar with their individual care needs, wishes and daily routines. Staff still followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. Our rating for this key question has therefore changed from requires improvement to good.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us the provider learnt lessons when things went wrong and acknowledged when they could and should have done better.

Managers and staff told us incidents involving the people they supported were always logged and analysed. Staff confirmed information about any lessons learnt were always shared with them during individual and group meetings with their line manager. The manager encouraged an open and transparent culture about safety at the service where people received a service, their representatives and staff could raise concerns without fear about what might happen.

The provider learnt lessons when things went wrong. The manager continually reviewed incidents to determine potential causes and identify any actions they needed to take to reduce the likelihood of reoccurrence and learn lessons so they could continually improve. This information was shared and discussed with staff during individual and group meetings.

People told us they were invited to participate in an assessment process prior to them receiving a care service from this provider. People told us they received the personal care and support that was planned in accordance with their assessed needs and wishes.

The manager told us people's personal care needs were assessed before they were offered the opportunity to receive a home care service from them. The manager confirmed these initial assessments were used to help staff develop person-centred care plans for everyone they supported.

No feedback was received from any external health and social care professionals.

People’s care plans were based on assessments conducted by the provider and various external health and social care professionals. These care plans included detailed information for staff about how to support people with their personal care and support needs. We saw care plans had been developed for everyone currently receiving a service from the provider.

People told us they felt safe with the staff who supported them at home. A person said, “I do feel safe with the staff who regularly visit me.” A relative added, “My [family member] is looked after well and kept safe by all the carers who regularly come and see us at home.”

Managers supported staff to protect people from abuse. Staff received safeguarding adults training as part of their induction which staff confirmed was routinely refreshed. Staff knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A member of staff told us, “If anyone I look after is harmed, mistreated or neglected, I will make sure I report this immediately to the office.” Another member of staff added, “I would immediately inform our manager, the local authority, and if necessary, the police, if anyone I supported was being abused.” Staff were routinely reminded about their safeguarding roles and responsibilities at individual and group meetings with their line managers and fellow co-workers. The office-based managers understood their legal responsibility to immediately refer any safeguarding incidents or concerns to external agencies and bodies including, the relevant local authority, the CQC, and where necessary, the police.

Robust systems and processes were now in place to protect people from the risk of abuse. The provider had clear safeguarding policies and procedures which were up to date, in line with relevant legislation and accessible to all. The providers safeguarding and speak out/staff whistle-blowing policies and procedures were both included in the staff handbook supplied to all new staff.

People told us staff knew how to support them in a safe way to prevent and/or minimise the risks they might face. A person said, “Staff know how to look after me and what I need and like.” A relative added, “The carers know exactly how to look after my [family member] and keep them safe.”

Care staff were aware of people's daily routines, preferences and needs, and knew what action to take to reduce or safely manage potential risks they supported might face. A member of staff told us, “We are trained to use safe moving and transferring practices and to keep a close eye on people with mobility needs to stop them falling. We also regularly check the skin of people who might be at risk of developing pressure sores.”

People's care plans now included up to date risk assessments and management plans. This meant staff had access to all the information and guidance they required to prevent or safely manage potential risks people they supported might face. These assessments and management plans covered every aspect of people’s lives, including for example, risks associated with moving and handling and falls prevention, infection control, nutrition, and managing pressure sores. These risk assessments and management plans had been regularly reviewed and updated accordingly to reflect people's changing needs.

People told us staff from the office routinely came to visit them at home to check their home environment remained safe.

Managers were able to assure us that there were effective governance arrangements to monitor the safety of people's homes environment.

Health and safety risk assessments and management plans were conducted on the home environments where people using the service lived.

People told us staff who supported them never missed their scheduled call visits, were usually on time, and would always let them know if they were running late. People also said staff stayed and completed all the tasks they had agreed to as set out in their care plan and list of daily routines. A person remarked, “Yes, my carers always come on time and do all the jobs they’re meant too.” A relative added, “The carers are very rarely ever late visiting my [family member] and they will always let her know if they’re running late, which is usually because of traffic problems and not the staff’s fault. The staff always complete all the tasks they’ve been asked to do.” Furthermore, people told us they received continuity of care from a regular group of staff who were familiar with their personal care needs, preferences and daily routines. A person said, “I have the same carers every day.” A relative added, “Sometimes we might get a different carer at the weekend, but most of the time my [family member] gets the same two carers. This has helped my [family member] get to know her regular carers really well.” People were also positive about staffs’ knowledge and skills and said they were always kind and friendly. A relative told us, “Staff do seem to be a very well-trained and supported bunch.”

Staff told us their call visits were well-coordinated by the manager. A member of staff said, “I do feel I have enough time to attend my calls on time and to complete all the tasks I need too.” Another member of staff added, “My call visits are co-ordinated well. This is because the schedule gives me enough time to complete all my tasks and get to my next call on time.” The training staff received was always relevant to their role and was routinely refreshed to ensure their knowledge and skills remained up to date. Staff demonstrated good awareness of their working roles and responsibilities. A member of staff told us, “We get trained during our induction period before we’re allowed to start working in the field, after which we’re expected to keep on refreshing our existing training regularly.” Another added, “I have completed all my mandatory training, which included an induction. The training is always useful and helps me to understand how to do my job properly.” Staff had ongoing opportunities to reflect on their working practices and to identify any further training or learning they might need. This included regular individual and group supervision/team meetings with their line manager and/or fellow co-workers. Staff who had worked for this provider for over a year had also had their overall work performance appraisal by the manager. A member of staff told us, “We have to be supervised in the field by our assessor before we can start on our own and we have regular supervision and feedback sessions thereafter. I do feel supported by my employer.” Another added, “I am supervised every month in group meetings the manager holds in our offices.”

The provider now conducted thorough pre-employment checks to ensure the suitability and fitness of all prospective new staff. Records indicated the process was safe and was now followed. For example, we found the provider had obtained 2 references from previous employers in relation to all prospective new staff as recommended in their previous CQC inspection report. Other checks on prospective new staff included, their identify, right to work in the UK and whether or not they were registered with the Disclosure and Barring Service (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions. Training records indicated staff attended relevant courses to support them to meet a range of people’s needs. Training was refreshed at regular intervals to ensure staff continued to remain up to date with recognised best care practice. The training of new staff included a comprehensive induction programme.

People told us staff always wore personal protective equipment [PPE] when they supported them with their personal care.

Managers and staff told us they had received up to date infection control and food hygiene training. A member of staff said, “The provider has implemented effective infection control measures, including providing us with enough PPE, such as rubber gloves, and regular training on safe infection control protocols.”

The provider followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. The provider had an up-to-date infection prevention and control policy in place.

At the time of our inspection, no one was receiving support from the agency to manage their prescribed medicines.

At the time of our inspection, no one was receiving support from the agency to manage medicines, although staff confirmed they received medicines training as part of their induction.

The provider had up to date safe management of medicines policies and procedures in place. Staff received safe management of medicines training.