Gentle Hands Home Care

Gentle Hands is a domiciliary care provider providing personal care to 36 people at the time of the inspection. It provides personal care to people living in their own homes, so they can live as independently as possible.

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

People received care from a consistent team of staff who had been provided with comprehensive training. Personal preferences were observed, and these were detailed in the person-centred plans.

Risk assessments had been completed and any know risks were mitigated. Staff understood the importance of reporting any concerns and these were investigated.

Staff were recruited safety and there were enough staff to support the needs of people using the service. During COVID-19 the provide had taken appropriate steps to improve infection control measures.

People were encouraged to share their views through telephone reviews and annual surveys.

A range of audits and systems were used to ensure that the quality of the service was maintained and there was an opportunity to drive improvement.

Rating at last inspection

The last rating for this service was Requires Improvement (published 02/10/2019).

Why we inspected

This was a planned focused inspection on the key areas Safe and Welled. This was based on the previous rating of Requires Improvement. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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 Gentle Hands on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Ashgate Home Care provides personal care to people living in their own houses and flats in the community. The Care Quality Commission only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection the service was providing personal care to 34 people.

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

People told us they received safe care and treatment. They spoke positively about the care staff and the support the service provided. People were not adequately protected from unsafe care practices because recruitment checks were not robust. People’s ability to receive person centred care was affected by staff shortages. They were supported with the safe use of medicines and staff knew how to report concerns about abuse.

People were supported by staff who had received a range of training to enable them to carry out their role safely. Staff supported people to have maximum choice and control of their lives, the policies and systems in the service supported this practice. People were asked to consent to their care. However, improvements were required to ensure people’s ability to make their own decisions was assessed. People received support to maintain good nutrition and hydration and their healthcare needs were understood and met.

We received mixed responses from people regarding the way they were treated. Some people told us staff treated them with dignity and were respectful however, some felt this was not always the case with some of the staff. Before the inspection we had received concerns from professionals regarding a staff member’s approach to caring for people. The registered manager took action to address this.

Care plans contained personalised information on people’s health and communication needs plus their likes and dislikes. People and family members knew how to make a complaint and they were confident about complaining should they need to. They were confident that their complaint would be listened to and acted upon quickly. Previous complaints had been adequately investigated and outcomes had been shared and used to improve care delivery.

The registered provider had governance systems to support the delivery of safe care. However, their systems needed to be improved to maintain safe recruitment practices. The registered manager showed they were committed to improving the service and displayed knowledge and understanding around the importance of working closely with other agencies and healthcare professionals where needed.

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

Rating at last inspection:

At the last inspection the service was rated good.

Why we inspected

This was a planned inspection based on the previous rating

Enforcement:

We have identified breaches in relation to the lack of robust staff recruitment checks at this inspection. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for 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.

This inspection took place on 11 November 2016. The service is run from an office in the Langley Mill area. The provider was given 48 hours' notice because the location provides a domiciliary care service and we wanted to make sure the registered manager was available. In addition we also made phone calls to people using the service on 22 November 2016.

There was a registered manager 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.

The service was following the guidance in people’s risk assessments and care plans and the risk of unsafe care was reduced. People’s records were up to date and indicated that care was being provided as detailed in people’s assessments. The records had been updated to reflect changes in people’s care needs. Medicines were managed safely.

People were safeguarded from abuse because the provider had relevant guidance in place and staff were knowledgeable about the reporting procedure. The provider's arrangements for staff recruitment and deployment helped to make sure there were sufficient staff who were fit to work at the service to provide people’s care.

Staff understood their roles and responsibilities for people's personal care and safety needs and for reporting any related concerns. The provider's arrangements for staff training and their operational procedures supported this.

The principles and requirements of the Mental Capacity Act (2005) were being met. People were supported by staff who knew them well. Staff were aware how to promote people’s safety and independence. People were provided with information to support them to make day-to-day decisions.

People received appropriate support to plan and manage their meals and nutrition. This was done in a way that met their needs and choices. People’s health needs were met. Referrals to external health professionals were made in a timely manner.

People and their relatives told us staff were caring and kind, and that their privacy and dignity was maintained when personal care was provided. People and their relatives were involved in the planning of their care and support.

There was a complaints process in place. The leadership of the service was praised by external professionals and relatives and communication systems were effective. Systems to monitor the quality of the service were effective and identified issues for improvement.