Gain Healthcare Ltd

Updated 17 May 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service currently provides care and support to 2 people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

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.

Inspection activity started on 24 March 2023 and ended on 29 March 2023. We visited the location’s office on 24 March 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 members of staff including the registered manager, supported living operations manager, a registered manager from another service within the same provider and 3 care workers.

We reviewed a range of records. This included 2 people’s care records and medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found and sought feedback from 9 professionals about their experience of the care and support provided by the service.

Updated 17 May 2023

About the service

Gain Healthcare Ltd is a domiciliary care and supported living service providing the regulated activity of personal care. At the time of our inspection there were 2 people receiving the regulated activity of personal care.

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 have made a recommendation about the systems and processes used to ensure the service are not depriving people of their liberties without the correct authorisation from the Court of Protection.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Safe recruitment practices had taken place to gather satisfactory evidence of staff conduct in all relevant previous employment. The model of care and setting maximised people’s choice, control and independence. People who experienced periods of distress had proactive plans in place which ensured restrictive practices were only used by staff if there was no alternative.

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. However, people had been deprived of their liberty without the appropriate legal authorisations being sought from the Court of Protection. Whilst this was not the immediate responsibility of the provider, they had not through their own systems, identified or taken action in response to this shortfall. We raised this with the registered manager who took immediate action.

Right Care: People were protected from abuse and poor care and any concerns were addressed. The service had enough appropriately skilled staff to meet their needs and keep them safe. People were able to communicate with staff and understand information given to them by staff who supported them consistently and understood their individual communication needs.

Right Culture: Staff spoke positively about the culture of the service and told us they placed people’s wishes, needs and rights at the heart of everything they did.

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 9 August 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.

At our last inspection we recommended that the provider refer to current guidance about best practice in end of life care planning. At this inspection we found no one was being supported with their end of life care and support but the registered manager was aware of their regulatory responsibility in relation to best practice guidance.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. 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.

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

Recommendations

We have made a recommendation about the systems and processes used to ensure the service are not depriving people of their liberties without the correct authorisation from the Court of Protection.

Follow up

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