GUTU

Updated 29 June 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 3 inspectors and 2 Experts 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 registered as a domiciliary care agency and a supported living service. The service provides care and support to people living in 'supported living' settings, 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

This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 25 April 2023 and ended on 11 May 2023. We visited the location’s office on 25 and 26 April 2023. We carried out phone calls to people, relatives and staff on 26 and 27 April 2023 and visited 2 people in their homes on 26 April 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who commission the service. We also sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. Healthwatch told us they had not visited the service or received any comments or concerns since the last inspection.

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

During the inspection

We spoke with 3 people who used the service about their experience of the care provided. We spoke with 14 people's relatives. We spoke with 21 members of staff, including; support workers, senior support workers, service managers, the registered manager and the chief operating officer for the service.

We reviewed a range of records. This included 7 people's care records and multiple medicines records. We looked at 4 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.

Updated 29 June 2023

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.

About the service

GUTU, also known as Time 4 U, is a domiciliary care agency. The service was providing personal care to 25 people at the time of the inspection across Medway and Kent. The service provides supported living to people with physical disabilities, learning disabilities, autism and/or mental health needs. People live in their own houses and flats. Some people lived in small shared houses and some people lived alone.

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

Right Care

Risk assessments did not always have information staff needed to keep people safe.

People's care was person centred and met their assessed needs. Support plans were in place which detailed how staff should support people. Relatives said, “Staff are amazing. The care is fantastic”; “They absolutely respect him” and “They are very caring staff and very much know what they are doing, they have great empathy.”

Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough staff to meet people's needs and keep them safe.

Right Culture

The provider had quality monitoring processes in place. These were not always robust and had not always identified concerns and improvements in the service identified during the inspection.

Since the last inspection, people, their relatives and staff had been encouraged and supported to provide feedback about the service. Most people and staff felt listened to.

Right Support

Staff supported people to achieve their aspirations and goals and assisted people to plan how these would be met. Relatives said, “They are very good at making sure she is as independent as possible; she washes herself, takes her plates in. They have improved her self-management, she hoovers and is keeping her space tidy, she is very proud of her flat. Her needs are being met” and “They are encouraging independence. He takes his own medication, under supervision, he has his own front door key, he cleans the bath, although he is a reluctant participant.” The service had systems and processes in place to safely administer and record medicines use. Medicines were administered in line with the prescription.

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 19 August 2021). 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 the provider remained in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last 3 consecutive inspections.

Why we inspected

We carried out a focused inspection of this service on 29 June 2021. Breaches of legal requirements were found. 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 remained requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe 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 full report.

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

Enforcement

We have identified breaches in relation to risk management and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

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.