Goodwill and Hope domiciliary care agency provides care and support to people in their own homes on a short and long term basis. At the time of our inspection 37 people were using the service.
There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
This was our first inspection of this service.
We received positive feedback about the staff, the culture of the service and its leadership. People were positive and described staff as respectful, caring, and helpful. People and their relatives experienced kindness and consideration during care visits. People and their relatives knew how to raise concerns and generally felt their concerns would be addressed to their satisfaction.
The provider strived to improve the outcomes for people. However, we found the provider did not robustly monitor the safety and quality of the service so that they could effectively and independently identify areas that required improvement. People’s safety and quality of care might be compromised and the provider would not always be able to respond appropriately and without delay before potential harm might occur. The registered manager used the opportunity when out working with people and staff to assess the quality of the service. Some audits had been completed but systems in place did not effectively identify factors that could impact on the operation of the service, such as the concerns we found in relation to recruitment and care reviews.
Staff recruitment practices were not sufficiently robust to protected people as far as possible from individuals who were known to be unsuitable to deliver care in people’s homes.
People were supported by trained care staff who received regular supervisions to support them to develop their knowledge and skills when supporting people. There was sufficient care staff to ensure people received their care as required and staff knew how to care for people appropriately. Systems for reporting and escalating concerns were implemented effectively to ensure action was taken to keep people safe. People who required visits at specific times to manage their health conditions generally received their visits on time. However, people’s care records did not always provide staff with sufficient details of people’s health conditions and changing needs to ensure staff would consistently know how to care for people from reading their care plans.
We found people and their relatives were encouraged by the provider to plan their own care and people received their care when and how they wanted. People got the time they required to complete their personal care routine at their own pace and did not feel rushed.
We found improvements were needed in the way the provider regularly assessed people’s needs and reviewed people’s care to ensure this met people’s needs and managed risks. The changing needs of people with dementia had not always been routinely assessed to ensure people’s care continued to meet their needs in line with national good practice guidance.
The provider did not have suitable arrangements in place to obtain the consent of people in relation to the care provided where they had appointed a legal representative to act on their behalf. We recommend the provider seeks advice and guidance based on current best practice from a reputable source, on how to record the nature and involvement of people’s LPAs in best interest decisions.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.