Background to this inspection
Updated
6 January 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 09 and 10 November 2016 and was announced. We gave the service 48 hours’ notice, as the location provides a domiciliary care service and we needed to ensure senior staff members would be in the office to facilitate the inspection, as well as allowing time to arrange for staff to be available to meet with us.
The inspection team consisted of one adult social care inspector from the Care Quality Commission (CQC).
Prior to the inspection we reviewed all the information we held about the service including statutory notifications and safeguarding referrals and contacted external professionals from the local authority commissioning and safeguarding teams.
As part of the inspection we spoke to the registered manager, deputy manager, senior care co-ordinator, care-coordinator, six staff members and six relatives of people who used the service. Due to most people using the service having limited or no communication skills, it was not possible to speak to them directly.
We looked at five care plans, five staff files, two Medication Administration Record (MAR) charts and also reviewed other records held by the service including audits, meeting notes and safety documentation.
Updated
6 January 2017
We carried out an announced inspection of GS Social Care Solutions Ltd on 09 and 10 November 2016. The service had last been inspected in July 2013 when we found the service to be compliant with all regulations assessed at that time.
GS Social Care Solutions Ltd is a specialist domiciliary care agency providing support for children, adults and older people within their own homes or out in the community. The service also offers a 2 bedded respite service which caters for ages 0 – 25. ‘The Meadows’ is predominantly for overnight stays and is aimed at people with learning disability, autism, complex health needs or physical disability. A charity set up by the organisation, the Elysium Community Centre, is also run from the same address and includes a large sport hall, which provides activities that people using the service could access. At the time of the inspection a total of 88 people used the service, however only 32 people were in receipt of regulated activities and therefore included in the inspection.
At the time of the inspection there was a registered manger in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
A large proportion of the people supported by the service were children or young adults, many with limited or no verbal communication skills. As a result we were only able to speak to relatives of people who used the service. All the relatives we spoke with told us they were happy with the service being provided and their family member felt safe as a result of the care and support received. We saw the service had suitable safeguarding policies and procedures in place. Staff had all received training in safeguarding vulnerable adults and were able to demonstrate a good understanding of how to report both safeguarding and whistleblowing concerns.
Both staff and relatives of people using the service told us enough staff were employed to meet peoples’ needs. Staff told us enough time had been allocated for travelling between calls and many worked solely with the same person, which ensured consistency. Each person using the service had a small team of staff that supported them. We saw that any sickness or other absence had been covered by another member of the team, or if this hadn’t been possible, the person and/or their relative had been consulted with before an unfamiliar member of staff used. On occasions we saw that the care-coordinator responsible for a person’s care, had completed the shift rather than use someone unfamiliar.
We saw that robust recruitment procedures were in place to ensure staff working for the service met the required standards. This involved all staff having a DBS (Disclosure and Baring Service) check, up to three references and work history documented. A DBS check helps a service to ensure the applicant’s suitability to work with vulnerable people.
Staff reported that they received an appropriate level of training to carry out their role. We saw all staff completed a comprehensive induction training programme, followed by a flexible period of time shadowing experienced care staff, before being allowed to work with people who used the service. We saw the service had systems in place to ensure that staff received regular refresher training to ensure their skills and knowledge remained up to date. Staff told us that training was encouraged and they could request to attend any courses or training of interest.
Most of the relatives we spoke with confirmed they had taken responsibility for administering medicines, however positive feedback was given where staff had been involved. Within The Meadows we saw there were systems in place to ensure safe medicines management was maintained. All medicines had been booked in and out, with the relative of the person using the service countersigning all documentation.
Relatives spoke highly of the standard of care received and the caring nature of the staff. They told us that staff treated their relatives kindly, with dignity and respect whilst also promoting their independence wherever possible.
We looked at five care plans, which contained detailed and personalised information about the people who used the service. The care plans also contained individual risk assessments, which helped to ensure people’s safety was maintained. We saw that people or their relatives had been involved in planning the care provided and were asked for their feedback through completion of reviews, spot checks and questionnaires.
The service had implemented a number of systems and strategies to ensure care being provided was person centred. We saw that specific interventions and guidelines had been devised to address potential issues a person may encounter when using the service. These had been drawn up with the involvement of the person and/or their relative and in one instance led to bespoke training being devised for all staff members allocated to that person’s team.
A weekly schedule of activities was offered, the majority of which were facilitated by the charity, run separately by the service. We saw that sessions were both age specific and also mixed to encourage intergenerational involvement. People were able to choose their own weekly schedule of activities and attend whatever social activities they wanted.
We saw that there were a range of systems and procedures in place to monitor the quality of the service. Quality assurance questionnaires were sent out to people using the service and/or their relatives, along with professionals and staff members on a bi-annual basis. On-going reviews and spot checks were completed to ensure care being provided was effective and met the needs of the people using the service.