Gemstone Care Ltd

Updated 22 November 2019

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 Care Act 2014.

Inspection team

This inspection was carried out by one Inspector and an Expert by Experience. 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with six relatives of people who used the service about their experience of the care provided. We also spoke with three members of staff including the registered manager.

Updated 22 November 2019

Gemstone Care Limited is a domiciliary care agency which provides 24 hour care and support across four supported living locations to people with a learning disability. At the time of our inspection nine people were using the service who were supported in their own homes.

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

People, their relatives and professionals routinely described the staff as knowing people exceptionally well, and the care people received as being exceptional, excellent, brilliant and wonderful.

Innovative and creative ways were used to deliver bespoke and personalised care and support to people. People's health and wellbeing was closely monitored to ensure they received timely and appropriate treatment. Transitions between services continued to be effectively managed and was meticulously well planned.

People were encouraged to live as full a life as possible and supported to achieve the best possible outcomes. Staff had formed positive relationships with the people they supported and looked for ways to make them feel valued. People were genuinely encouraged to express their hopes and dreams and the service looked for ways to make these a reality. Staff knew people really well and used this knowledge and support them to achieve their goals. Staff were considerate of people's feeling at all times and treated people with the utmost respect and dignity.

People received highly personalised support from staff who knew them well. People were encouraged and supported to reach their goals. People's confidence, independence and health outcomes had improved since they began using the service. People's achievements were recognised and celebrated. People were enabled to maintain relationships with those who mattered to them.

Staff were aware of safeguarding procedures and knew the correct action to take if they suspected abuse had occurred. There were enough staff to meet people's needs in an inclusive way. Prospective employees had been recruited inclusively, with people who used the service. People were supported by a consistent staff team who were aware of the risks to people and knew how to manage these safely. Medicines were administered, stored and disposed of safely. Infection control practices were robust and promoted the principles of individual awareness and ownership.

The level of care and support given to people enabled them to have an excellent quality of life. Staff understood and knew how to apply legislation to help people make decisions and give their consent to treatment. Where restrictions were in place this was in line with appropriate guidelines.

People were supported by staff who had exceptional skills and knowledge to meet their assessed needs. People had enough to eat and drink and arrangements were in place to identify and support people who had been identified as being nutritionally at 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 had access to a wide range of personalised and group activities and were supported to have a say in all aspects of how the service was delivered. People were supported to have as many opportunities as possible, so they could gain new skills and live more independently.

People benefitted from a service that had a dedicated registered manager whose experience and qualifications were used to support people to lead full and meaningful lives. The values of the provider were consistently demonstrated by staff in their interactions with people and with each other. People's views were sought out and acted upon.

Robust quality assurance processes ensured the safety, high quality and effectiveness of the service. People felt listened to and their views were taken into account. These were used to shape 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 outstanding. (27 January 2017)

Why we inspected This was a planned inspection based on the previous rating.

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.