Background to this inspection
Updated
19 July 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
The 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
This was an unannounced inspection.
What we did before the inspection
Before the inspection visit, we reviewed information we had received about the service since the last inspection. This included information about incidents the provider must notify us of, such as any allegations of abuse. We sought feedback on the service from the local authority and local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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.
During the inspection
We spoke with the proprietor, registered manager, administrator and four care workers. We also reviewed a range of records. These included four people’s care records, medication records, staff training records, three staff files in relation to recruitment, selected policies and incident and accidents records.
After the inspection
We spoke with four people, four relatives and two community health and social care professionals about their experiences of care provided.
Updated
19 July 2019
About the service
The Garth Care Services is a domiciliary care agency based in Kington, Herefordshire. It specialises in providing care and support to older people with physical disabilities, sensory impairments or who are living with dementia. At the time of our inspection, there were 9 people using the service.
People’s experience of using this service and what we found
The provider’s systems and procedures to help people manage their medicines needed to be more robust and consistently adhered to by staff. Staff training needs had not been effectively monitored and consistently addressed. The provider’s quality assurance activities were not as effective as they needed to be. They had not enabled them to address the shortfalls in quality we identified during our inspection.
People were protected from abuse by staff who understood how to identify and report any abuse concerns. The risks to people’s health, safety and welfare had been assessed, reviewed and plans put in place to keep them safe. The provider monitored their staffing requirements to enable them to provide a reliable and consistent service. The registered manager reviewed all reports of any accidents or incidents involving people to learn from these. Steps had been taken to protect people, staff and others from the risk of infections.
The registered manager met with people and their relatives before their care started, to assess their individual needs and requirements. Staff received an effective induction to help them settle into their new roles. People had the support they needed from staff to prepare their meals and drinks. Staff and management worked effectively with a range of community health and social care professionals to ensure people’s health needs were monitored and addressed. 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.
Staff were friendly, caring and spoke to people in a respectful and polite manner. People and their relatives were able to express their opinions about the care provided, and these were listened to by the provider. Staff understood the importance of promoting people’s equality and diversity through their work.
People’s care and support reflected their individual needs and requirements. People’s care plans encouraged a person-centred approach and were reviewed and updated on a regular basis. People and their relatives understood how to raise any concerns or complaints with the provider. People’s wishes and choices about their end of life care were explored with them, in order that these could be addressed.
The provider and management team promoted an open culture within the service, in which feedback from people and other stakeholders was encouraged and listened to. Staff were well-supported by an approachable management team who were willing to act on issues and concerns brought to their attention.
Rating at last inspection
The last rating for this service was good (published 7 September 2016).
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.