G&P Healthcare Limited

G&P Healthcare Limited is a domiciliary care service delivering care and support to people in their own homes. It delivers services to adults, children and young people.

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

Everyone complimented and highly praised the staff team and gave examples of the outstanding care that was delivered. One relative said, “The staff really seem to understand, it is more than a job for them, they are handpicked” and “The staff are great with the whole family. I was terrified about having people in the house but as well as being great carers my kids love them too.”

People were extremely well-cared for. Staff knew the people they were supporting very well and care was provided with exceptional patience and kindness. The service went to great lengths to ensure people's privacy and dignity were always respected.

Staff were highly trained, knowledgeable and passionate about the service giving people the very best experience they could. People told us they were highly appreciative of the support provided to them. A relative commented, “Their communication round the rota and the staff being so well trained are the best points. I didn’t think I would ever cope with [Name] being out of hospital and having carers looking after them, but it is brilliant, it works really well.”

Robust systems were in place to ensure care was extremely person-centred and to make sure people were at the heart of the service. This vision was driven by the exceptional leadership of the registered managers. Staff consistently told us, “It’s the best care organisation I’ve worked for.” A professional commented, “I deal with a few care firms with my clients and I have never come across another one as good as this.”

Care was completely centred and tailored to each individual. Risk assessments were in place and they identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks, including for positive risk taking.

The service was very flexible and adapted to people's changing needs and desires, enabling positive outcomes for all people. Records were very well-personalised, up-to-date and accurately reflected people's care and support needs. Effective systems were in place to identify what each person wanted to achieve, and how best to support them to do this. There was clear evidence of collaborative working and excellent communication with other professionals to help meet people's needs.

People were encouraged and supported to lead as fulfilled a life as possible. People were supported to foster their dreams and aspirations. There were several examples where staff had really gone the extra mile and supported people in different aspects of their lives.

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.

Staffing capacity was sufficient and staff deployment was effective to ensure people's needs were met in a safe, timely and consistent way. Systems were in place for people to receive their medicines in a safe way.

People, relatives and staff were very confident about approaching the registered managers if they needed to. They recognised that their views and feedback were valued and respected and consistently used to support quality service development.

Strong processes were in place to manage and respond to complaints and concerns. The registered manager and management team undertook a range of audits to check on the quality of care provided.

Staff were encouraged to continue their professional development in order to progress and provide the best outcomes for people. Staff demonstrated that they really understood the importance and benefits of providing person-centred care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Outstanding (published 20 March 2020).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

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

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.

G&P Healthcare Limited is a domiciliary care service delivering care and supporting people in their own homes. It delivers services to both adults and children and young people. At the time of the inspection the service was supporting three adults and five children and their families.

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

People and relatives told us the care they received was exceptional and highly tailored to their individual needs.for people. Professionals praised the service and said the care people received was extraordinary and outstanding. People and relatives were encouraged to express their views about the care and were involved in decisions making, as far as they were able. Staff had a deep understanding of people’s individual choices and fully respected their right to privacy. People were encouraged to maintain their independence and staff supported them to extend their abilities.

The registered managers had an exceptionally clear idea about the service they wanted delivered, that was high quality and very personal. Professionals told us the provider was one of the best services they had every worked with. They told us the service was an excellent and willing partner in ensuring and delivering high quality care. People were supported to input into the service and the delivery of their care packages. Staff and managers maintained their skill and knowledge and professionals told us the service was highly accomplished in supporting people.

Care plans and care delivery were extremely personal and tailored to the needs of the individual. Professionals confirmed the support people received was fully focussed and particular to each person. People’s communication needs were well supported, allowing them to wholly contribute to the care process. People were supported to engage in a range of activities and maintain contact with their families and local communities.

Parents felt the children and young people the service cared for were safely supported. The provider had dealt appropriately with any potential safeguarding concerns and whistleblowing matters. Risks were assessed and mitigated to keep people safe. Staff recruitment was carried out safely and effectively. People were correctly supported with their medicines.

People’s needs were fully assessed, and their choices respected during the delivery of care. Staff had received a range of training specific to the needs of the individuals they cared for. People were supported to maintain their wellbeing and were encouraged to sustain a healthy diet. Staff worked extremely closely with an extensive range of other agencies to ensure care and supported was delivered seamlessly.

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. There was no one being supported by the service who was under any legal restrictions.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: The last rating for this service was good (published 16 August 2017.)

Why we inspected

This was a planned inspection based on the previous rating.

G&P Healthcare Ltd provides nurse-led care in people’s own homes. Nurses carry out visits to plan people’s care and to regularly monitor people’s needs and the care provided. Delivery of care is provided by trained care workers. At the time of our inspection the service was supporting 14 packages of care, delivering support to 15 individuals. Nine of the individuals being supported were children or young people.

The service had a registered manager who had been registered since July 2016. A registered manager is a person who has registered with the Care Quality Commission 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. The registered manager was also the nominated individual for the service provider.

The provider had in place a safeguarding policy and staff had received training in relation to the safeguarding of vulnerable adults and children. Staff said they would report any concerns to the manager or senior staff. There had been two recent safeguarding incidents in the service which had been dealt with appropriately and reported to the appropriate authorities. Risk assessments were in place linked to care delivery in each person’s home. Regular checks were maintained to ensure the risk assessments were up to date.

Staffing was delivered through the development of teams around individual care packages. People told us that in the main they were support by the same group of care staff. Staff told us there were sufficient staff to deliver individualised care. Proper recruitment procedures and checks were in place to ensure staff employed by the service had the correct skills and experience. Medicines were managed and handled safely. There were plans in place for the use of ‘as required’ medicines and the use of covert medicines, where necessary. Specialist instructions were available if medicines were administered through PEG feed systems.

People were supported to access adequate levels of food and drink. Where specialist feeding systems were in use staff had received training of how to do this safely and appropriately. Staff had their competency monitored in the use of these feeding methods.

Structures were in place to ensure staff had regular training and updating of skills and staff confirmed this was the case. Records indicated the majority of staff had completed all mandatory training. Staff told us, and records confirmed there were regular supervision sessions for all staff members and each staff member had an annual appraisal.

The registered manager had a good understanding of the Mental Capacity Act 2005. No one being supported by the service had any restrictions on their freedom granted by the Court of Protection. Where people did not have capacity to make decisions best interests decisions had been taken and documented. It was not always possible to be sure family members had been fully involved in these decisions. We have made a recommendation about this.

We observed good and relaxed relationships between people and staff. Staff understood about people’s individual needs and personalities. People were supported to access health care professionals and services to help maintain their wellbeing. Specialist advice was sought and acted upon, where necessary. Staff understood about treating people with respect and dignity and people and relatives confirmed they put this into practice.

People’s needs had been fully assessed and individualised care plans and risk assessments developed that addressed all their identified needs. Care records and care plans were reviewed to ensure they met individual’s needs and potential changes were identified. People were supported in activities or their own interests and likes. Complaints had been dealt with appropriately and people told us the registered manager was responsive to any concerns.

The registered manager and senior staff directly visited people’s home to review care delivery, care records, staff competency and ensure people had the opportunity to raise any concerns. Records returned to the office were subject to audit and review and action taken where necessary.

People, relatives, professionals and staff were extremely positive about the registered manager and her individual and highly dedicated approach to the service and its quality. They told us she maintained regular contact, visited frequently and was responsive to any issues that needed addressing or updating. Staff said the registered manager and other senior staff were very approachable and freely available for support and advice. They said the registered manager could be contacted at any time. Staff said they enjoyed working in the service and supporting people.

The registered manager told us she was committed to providing a quality service and ensuring all staff were well trained. Professionals we spoke with told us the registered manager was very flexible in her approach and was exceptionally knowledgeable. Other services told us the provider worked well with them and there was good co-operation and communication. The registered manager and clinical lead maintained some nursing shifts within local NHS organisations to ensure they had access to up to date training and development. Records for the service were complete and contained very good detail.