Grande Care Ltd

Grande Care Limited is a domiciliary care service providing personal care to people in their own homes. The service provides support to people with complex needs, older people, and those with mental health needs, dementia and physical disabilities. At the time of our inspection there were 8 people using the service. 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

The management of medicines required improvement. Risks were not always assessed which put people at risk of receiving unsafe care. Governance systems and processes did not provide an effective means of identifying where improvements were needed, to ensure the service was safe and met regulatory requirements.

Staff understood how to manage risks to people’s health and safety. People and their relatives told us they felt safe with the care they received. The registered manager understood their legal responsibilities to protect people and share important information with the local authority and CQC. People received care and support from a consistent staff team who had time to get to know their individual needs and preferences and staff were recruited safely. Staff received training in infection prevention and control and were provided with Personal Protective Equipment (PPE).

The provider assessed people’s needs and choices before they began using the service. The provider's induction and training provided staff with the skills and competencies needed to carry out their roles effectively. People were supported to access other health professionals as required. Staff followed advice and guidance provided by health professionals to meet people’s nutritional needs.

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.

We received positive feedback from people, their relatives and staff about Grande Care. The registered manager had a clear vision and ethos for the service which was to provide people with a small staff team they could build confidence with and develop trusted relationships. People were given the opportunity to provide feedback on care through regular home visits carried out by the registered manager. Important events and incidents were reported to CQC as per regulatory requirements. The registered manager worked in partnership with other health and social care professionals to ensure positive outcomes for people.

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 15 August 2018).

Why we inspected

We received concerns from the local authority's safeguarding team regarding the quality of personal care people received to maintain their personal hygiene. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only to examine those risks. We found no evidence to support these concerns, but we have found evidence that the provider needs to make improvements in other areas of care. Please see the safe and well led sections of this full report.

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 changed from good to requires improvement based on the findings of this inspection.

Enforcement

We have identified breaches in relation to safe care and treatment 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

Grande Care Ltd is registered to provide personal care to people in their own homes and was registered with us in June 2017. This was the first inspection of this service following registration with us. At the time of this inspection, the service was providing four people with personal care.

There was no registered manager in place. 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 provider was managing the service and is referred to as ‘the manager’ in the inspection report.

People received care from a consistent staff team who arrived when they were expected and stayed the allocated time. People felt safe with care staff because they had been trained to provide effective care that met their individual needs and preferences.

People had an assessment of their care needs completed at the start of the service that identified any potential risks to providing their care and support. People’s care plans included the actions staff should take to minimise the identified risks. Staff understood their responsibility to work in a safe way and to report any concerns about people’s health and wellbeing to the manager.

People were fully involved in planning and reviewing their care and had been consulted about how they liked their care undertaken and what mattered to them. Staff worked in partnership with people and sought their consent before each care intervention.

People were treated with care and kindness by staff who took time to know them and understand their needs. Staff had received training in equality and diversity and treated people with respect. People told us staff communicated effectively with them to ensure their wellbeing.

People were given a copy of the complaints policy and knew how to raise any concerns.

People spoke very highly of the leadership of the service and the quality of care provided by Grande Care Ltd. Staff told us they were part of a supportive team and management support was available. However, whilst there was governance and accountability arrangements in place, as the service was quite new and only provided care to a small number of people, it was not possible to fully assess if the systems to learn, improve and ensure sustainability were fully effective.