6 March 2018
During a routine inspection
Not everyone using Guardian Homecare – Bedford receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating.
This was the first inspection of Guardian Homecare – Bedford since it registered with CQC in March 2017. This means the service has not previously been rated. During this inspection, which took place on 06 and 07 March 2018, we rated the service as Good.
A registered manager was in post. 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.
During the inspection we did identify some areas that needed improvements. However, we also saw evidence that the provider was aware of these and was already taking steps to address them. This included the timing of care calls to people. Overall, people told us that the service was reliable, but sometimes care staff did not arrive when they needed them to. The registered manager showed us that weekly analysis of call timings was underway, in order to provide an improved service to people.
The provider carried out checks on new staff to make sure they were suitable and safe to work at the service. However, we found some gaps with the recruitment checks carried out. These gaps were investigated and filled by the registered manager shortly after the inspection.
In addition, we found concerns with how staff recorded whether people had received topical medicines such as barrier creams. This is because staff had not always used the correct code (key) to record the reason for administering the cream. The management team showed us that training booklets had been prepared for staff to complete, to support them in their understanding of expected record keeping standards.
People were protected from abuse and avoidable harm. Staff had been trained to recognise signs of potential abuse and knew how to keep people safe. Processes were also in place to ensure risks to people were managed safely and that they were protected by the prevention and control of infection.
There was evidence that the service responded in an open and transparent way when things went wrong, so that lessons could be learnt and improvements made.
People received care and support that promoted a good quality of life and was delivered in line with current legislation and standards. Staff received training to ensure they had the right skills, knowledge and experience to meet people’s needs.
People were supported to have enough food and drink to maintain a balanced diet. Risks to people with complex eating and drinking needs were being managed appropriately.
Staff worked with other external teams and services to ensure people received effective care, support and treatment. People had access to healthcare services, and received appropriate support with their on-going healthcare needs.
The service acted in line with legislation and guidance regarding seeking people’s consent.
People received personalised care from staff who were helpful, kind and compassionate.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.
People’s privacy, dignity, and independence was respected and promoted.
Arrangements were in place for people to raise any concerns or complaints they might have about the service. These were responded to in a positive way, in order to improve the quality of service provided.
Systems were in place for people to be involved in making decisions about their end of life care needs, so if the need arose staff would be prepared and able to carry out those wishes.
There was strong leadership at the service which resulted in people receiving high quality and person centred care. The registered manager ensured that staff understood their legal responsibilities and accountability. This approach had created a positive culture that was open, inclusive and empowering for the people using the service.
Systems were in place to monitor the quality of the service provided and to drive continuous improvement. The registered manager and provider worked in partnership with key organisations and agencies for the benefit of people using the service.
Further information is in the detailed findings below.