We carried out a review of the data available to us about Gain Healthcare Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Gain Healthcare Ltd, you can give feedback on this 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.
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 15 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
The provider’s systems and processes had not been effective in assessing, monitoring and mitigating risks to the health, safety and welfare of people using the service. The provider had some quality monitoring processes in place, but these had not always been effective as they had not enabled the provider to identify and address the issues we found during the inspection as well as the previous inspection. This placed people at risk of harm.
The provider had not always followed the required safe recruitment practices to help ensure suitable people were employed.
We had concerns from relatives that staff were often late or visits shorter than expected which impacted at times on people receiving the medicines they required.
The provider had failed to ensure there were accurate and complete records in respect of each person, to evidence the care and treatment provided to them was in line with their assessed needs. Records held conflicting information and did not always reflect current best practice of care planning. This meant people were at risk of not receiving the care and support they required.
We have made a recommendation about the provider referring to current guidance about best practice in end of life care planning.
Relatives told us they felt their family members were provided with safe care. They also felt that staff were kind, caring and patient.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
We last inspected this service at the previous premises (inspected 3 February 2021; published 9 December 2021). The service was not rated but there were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We imposed conditions on the provider’s registration to submit information regularly to the Commission.
Since the last inspection the service had moved offices and was registered by CQC at the new address on 14 October 2021. We have used the previous inspection findings to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was the first inspection of the service under the new office registration. Although the address for the service changed following our previous inspection the provider remained the same. They had had full knowledge of the service’s inspection history and were responsible for maintaining and improving the service, including addressing any issues from the last inspection. The inspection was prompted in part due to the concerns identified at the previous inspection with the same provider.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well Led sections of this full report. You can see what action we have asked the provider to take at the end of this report.
Enforcement and recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to regulations 12 (safe care and treatment), regulation 17 (good governance) and regulation 19 (fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We have made a recommendation about the provider referring to current guidance about best practice in end of life care planning.
Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.