GGW Care Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Based on the findings of this assessment we found the service had improved and addressed all the outstanding breaches we identified at their last inspection. This meant people were now kept safe and protected from avoidable harm. This was because the provider had followed the action plan they had developed after their last inspection and improved how they protected people from abuse, assessed and managed risk, managed medicines, recruited staff, and ensured staff were adequately trained and supported. In addition, the provider continued to have a positive culture of learning lessons when things went wrong. Care plans were still based on pre-assessments conducted by the provider and various external health and social care professionals prior to people receiving a service. People continued to receive continuity of care from a dedicated group of staff who were familiar with their individual care needs, wishes and daily routines. Staff still followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. However, although the provider had made improvements and was now moving in the right direction, we have only changed their rating from inadequate to requires improvement because they still need to demonstrate to us they can continue improving the safety of the service they provide people over a more sustained period of time.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us the provider learnt lessons when things went wrong and acknowledged when they could and should have done better. One person told us, “There have been times where I have said to the managers in the office not to send a carer back. They did listen to me and stopped the person I didn’t want coming back by replacing them with a carer I liked.”

Managers and staff told us incidents and accidents, safeguarding concerns, and complaints involving the people they supported were always logged and analysed. These incidents were routinely reviewed to determine potential causes and to identify any actions they needed to take to reduce the likelihood of similar incidents reoccurring. Care staff confirmed information about any lessons learnt were always shared with them during individual supervision meetings with their line manager. The registered manager encouraged an open and transparent culture about safety at the service where people receiving a service, their representatives and staff could raise concerns without fear about what might happen.

The provider learnt lessons when things went wrong. The office-based managers continually reviewed incidents and accidents, safeguarding concerns, and complaints, to determine potential causes and identify any actions they needed to take to reduce the likelihood of re-occurrence and learn lessons so they could continually improve. This information was shared and discussed with staff during individual and group meetings.

People told us they were invited to participate in an assessment process prior to them receiving a care service from this provider. People told us they received the personal care and support that was planned in accordance with their assessed needs and wishes.

Managers told us people's personal care needs were assessed before they were offered the opportunity to receive a service from the provider. The registered manager confirmed these initial assessments were used to help staff develop person-centred care plans for everyone they supported.

External health and social care professionals told us the provider collaborated with them to establish and maintain safe systems of care.

People’s care plans were based on assessments conducted by the provider and various external health and social care professionals. These care plans included detailed information for staff about how to support people with their personal care and support needs. We saw care plans had been developed for everyone currently receiving a service from this provider.

People told us they felt safe with the staff who supported them at home with their personal care. One person said, “I feel the safest I have ever felt with my regular set of carers…I definitely feel safe with this provider.” An external social care professional added, “Our Direct Payment clients who are with this provider are reviewed by our care management team and no concerns have been reported. I am not aware of any safeguarding alerts which have been raised for this provider.”

Managers supported staff to protect people from abuse. Staff received safeguarding adults training as part of their induction which staff confirmed was routinely refreshed. Staff knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. One member of staff told us, “I have a duty to report any acts of abuse I might become aware of involving the people I look after. I would always tell my supervisor or the managers in the office straight away about any abuse I might witness.” Staff were routinely reminded about their safeguarding roles and responsibilities at meetings and spot check observations of their working practices during call visits conducted by their line managers. The office-based managers understood their legal responsibility to immediately refer any safeguarding incidents or concerns to external agencies and bodies including, the relevant local authority, the CQC, and where necessary, the police.

Robust systems and processes were now in place to protect people from the risk of abuse. The provider had clear safeguarding policies and procedures in place which were up to date, in line with relevant legislation and accessible to all. The providers safeguarding policy was included in the staff handbook which could be easily accessed electronically on the handheld devices staff all used. The provider had a staff ‘Speak up/Whistle blowing policy in place which was now conspicuously displayed in the providers offices. Whistleblowing is the term used when a worker passes on information concerning perceived wrongdoing, typically witnessed at work. Managers worked well with external agencies, such as local authorities, the police and the CQC, and acted in a timely way to ensure people were safeguarded and protected from further risk.

People using the service and their relatives told us they were kept safe from the harm of risk by the staff and the service. Comments included, “Yeah, I am quite happy with them” and “I feel the safest I have ever felt with these carers, I feel definitely safe with GGW”. One person said staff knew how to hoist, which they did correctly and that they were also hoisted by 2 staff, as per their care plan. One person spoke about the care that was given in relation to their pressure sores. They said they were treated by the district nurses and the staff from GGW Care monitored them, applied creams and followed instructions. They also told us their pressure sores were getting better. Another person said, “They [staff] check my skin and would tell me if I had any sores. I have an air mattress. I’m pretty sure they would not overlook it and would let me know”.

Staff were aware of the risks to people and the steps they needed to take to support them. Staff we spoke with spoke about the people they supported and what areas they needed extra help in.

At the last inspection we found risks were not always identified or safely managed. For example, epilepsy risk assessments did not provide sufficient information about the type, nature frequency of seizures to guide staff. Care plans and risk assessments contained contradictory information about safe moving and handling techniques. At this inspection, improvements had been made in the above areas and the provider was no longer in breach of regulations. For example, an epilepsy care plan had been developed for the person after the last inspection. This contained details for care staff to refer to in the event of a epileptic seizure. At the last inspection we found risk assessment tools were not always completed accurately to identify the right level of risk. Where people were identified as at high or very high risk, there were no skin integrity care plans to guide staff on how to mitigate the risks identified by the provider's assessments. At this inspection, some improvement had been made in this area however we recommend the provider continues some development work in this. For example, one person had been assessed at high risk of developing pressure sores. However, the action plan within the electronic care plan system was blank. Upon further investigation, this was found to be a system issue. The registered manager raised this with the care pan provider who were investigating this technical fault. We recommend the provider continues to liaise with the care plan software provider to ensure this is put in place. In the meantime, the registered manager had included details on how to manage this risk within the support plan for the person. The care notes also gave information about the care and support given in this area.

People told us that staff helped to keep their home environments safe.

Managers were able to assure us that there were effective governance arrangements to monitor the safety and upkeep of the premises and equipment.

There are effective arrangements to monitor the safety and upkeep of people’s homes. The provider carried out assessments on people’s homes at the onset of any care visits to ensure any risks were identified and could be mitigated against. Training records showed staff received the appropriate training in relevant areas such as Fire Safety Awareness.

We received positive feedback from people and their relatives about staffing the the timeliness of care visits. One person said there has been no missed calls and calls were mostly on time. They also told us they had a regular team of care workers who visited them. Other comments included, “Nearly every single time they are on time. There are never any missed calls, they wouldn’t leave me without anyone. They do call if they are running late and I can call them.”

Staff that we spoke with told us they received regular and relevant training to support them in their roles and they were supported by managers to learn and continuously improve their working practices. Staff also told us they were given enough time to travel between clients. Managers told us there were enough staff suitably deployed to support people. Managers confirmed that people were allocated teams of care workers to help with consistency and ensure people received care from staff they were familiar with. Staff told us they were supported by the management team and were able to discuss their job roles in supervision, appraisal and team meetings. A member of staff told us, “We get good training, its face to face and online. We get regular supervision.”

The service was adequately staffed by people whose suitability and fitness to work in an adult social care setting had been thoroughly assessed. Recruitment procedures were robust, which helped ensure only staff checked as being safe to work with people were employed. The provider carried out checks on staff that applied to work at the service to make sure they were suitable to support people. They included checks in relation to identity, proof of address and Disclosure and Barring Service (DBS) checks. The DBS provides information about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. The provider used an electronic clocking in system to monitor care visits and ensure they were taking place on time. We analysed data from the provider’s electronic call monitoring system for April 2024, May 2024 and June 2024. We found a high percentage of calls, 92%, were on time and only 1% were later than 45 mins. The data also showed staff were given sufficient travel time between their visits and calls where a person needed 2 care workers to support them were arranged correctly. Newly recruited staff underwent an induction, which helped prepare them for the role of care worker. Records showed staff received training in topics that were relevant to their role and helped them meet the needs of people. Training included the Care Certificate. The Care Certificate is an identified set of standards that health and care professionals adhere to in their daily working life. Supervision and appraisal records showed staff had regular supervision meetings and an annual appraisal of their overall work performance with their line managers to support them in their role and identify any further training or learning they might need. The provider operated a system to monitor supervisions and ensure staff received regular supervision and an opportunity to meet with a manager on a 1:1 basis.

People told us staff used Personal Protective Equipment [PPE] effectively and safely. One person said, staff wore PPE “Without fail”.

Staff told us they were given adequate supplies of PPE which was delivered to them by the manager or one of the care co-ordinators.

The provider had appropriate policies in place with respect to infection prevention and control which were adhered to by staff. Training records showed that staff had received training in infection control and Food Safety and Hygiene.

People who received assistance from staff to help them manage their medicines told us staff always ensured they took their prescribed medicines as and when they should. One person said, “I have no issues with how the staff assist me with my medicines,” while a second person added, “Staff know how to manage my medicines safely.”

Staff were clear about their roles and responsibilities in relation to the safe management of medicines. As identified as an issue at the providers last inspection we saw appropriate action had been taken by the provider to ensure staff who supported one person with a specific ‘as required’ medicine had now all received training in its safe management. In addition, all staff received medicines training as part of their induction and their competency to continue managing medicines safely was assessed by managers at least annually or more frequently if required. A member of staff told us, “I received medicines training as part of my induction and every year we take a competency test with the managers to check we can still manage medicines safely.”

Medicines systems were now well-organised, and people received their medicines as and when they should. People’s electronic care plans now included more detailed guidance for staff about their prescribed medicines and how they needed and preferred them to be administered. This included protocols for people prescribed ‘as required’ medicines, and instructions from external health care professionals, which helped guide staff to manage these medicines safely. One member of staff told us, “We can access medicines risk management plans and administration on our hand held electronic devices, which are easy to follow and use, including instructions from community health care professionals.” In addition, none of the electronic medicines risk management plans we looked at contained contradictory information about who was responsible for administering people prescribed medicines, which had been identified as a concern at the providers last inspection. Medicines were regularly and audited by the office-based managers and supervisors observed how care staff managed medicines during their scheduled call visits as part of the providers monitoring of staffs working practices. The provider also operated an electronic medicines system. These electronic medicines administration records [eMAR] helped ensure the office-based managers would be automatically notified about the occurrence of any medicines error in real and could take immediate action to address such an incident. We found no recording errors or omissions on any eMAR sheets we looked at during this assessment.