GoodOaks Homecare

Good Oaks Home Care - Aylesbury is a service providing care and support to people in their own home. At the time of the inspection the service was supporting 39 people. This included both younger adults, people with physical or sensory impairments, and older people. Some people using the service lived with dementia or experienced other mental health support needs.

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

People told us staff were caring, compassionate and provided safe care. Staff supported people to maintain their independence where possible and involved people in day to day decisions about their care and support. We received several compliments regarding the approach of staff. One family member advised, “We are really satisfied with this service…we're happy with them and feel [relative] is in good hands.”

Staff, people and families told us the service was well-managed. People indicated the management of the service was accessible, supportive and approachable. Comments from relatives included, “The office are always easy to get hold of and sort things out” and “If there has been anything to sort out, they have got on and done it. They will also check everything is going OK whilst I am on [the phone]. They are all very approachable.”

Staff provided consistently positive feedback about the responsiveness of the registered manager. The registered manager provided a positive role model for staff and had worked proactively with the nominated individual, office staff and head office to make improvements since our last inspection. We have made a recommendation in relation to governance record keeping.

People received person-centred care which was responsive to their needs. Staff could speak in detail about people they support, with knowledge about people's likes, dislikes and preferred routines. People's needs were assessed, and care plans provided a detailed and holistic picture of people's needs, wishes and preferred routines.

People were supported by staff who were suitably inducted, trained and supported. Staff deployment aimed to provide continuity of care, including enough travel time to deliver punctuality. One person told us, “I have a small team that come to see me. I get a weekly timetable and they are pretty much on time within it.”

We found safe care and treatment was provided. People were safeguarded from risks of abuse and other risks, including infection control risks in relation to COVID-19. Safe medicines administration practice was promoted. The registered manager took appropriate action in response to accidents, incidents and complaints to promote people’s safety.

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.

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 6 April 2022) and there were breaches of regulation. 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 improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended the service ensure systems were operated to report incidents to CQC in accordance with requirements, and we also recommended the service review their approach, to ensure care is provided in a compassionate and supportive way. At this inspection we found improvements had been made.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Good Oaks Home Care – Aylesbury on our website at www.cqc.org.uk.

Recommendations

At this inspection we have recommended the service review their approach to ensure the recording of management and governance systems is effective in evidencing the management of risks to the quality and safety of the service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Good Oaks Home Care - Aylesbury is a service providing care and support to people in their own home. At the time of the inspection the service was supporting 64 people. This included both younger adults, people with physical or sensory impairments, and older people. Some people using the service lived with dementia or experienced other mental health support needs.

The service offered both regular daily visits to people receiving personal care and live-in staff members providing a 24-hour support service. At the time of our inspection one person was receiving live-in support.

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

We found risks to people using the service were not clearly identified and managed. We also identified concerns in relation to safeguarding people from abuse, the safe management of medicines, concerns regarding staff testing for COVID-19 and a lack of robust oversight in relation to accidents and incidents. Most people told us they felt safe, with comments including, “I do feel safe when the staff are here” and “Very good, very nice, very capable.” Some people were concerned staff were rushed, and staffing rotas had not been consistently well managed. One person told us, “Staff are always in a rush.”

Some people told us staff provided kind and caring support, with comments including, “Even if I am feeling rotten the staff will make me smile, they are very good” and “I have a good rapport with the staff and I am happy with the care.” Some people raised concerns they felt rushed by staff and told us they struggled to understand and communicate with staff effectively. We have made a recommendation in relation to people receiving care which is dignified and compassionate.

Care assessments and care plans did not always promote person-centred care. Care reviews had not been carried out at frequencies required by the provider, and care plans contained varying levels of detail about people's needs and preferences. Some people received care from male and female staff, and we were not satisfied people’s preferences for staff gender had been fully explored, documented and met. We also identified concerns in relation to the recording and management of complaints, although some people told us their concerns or complaints had been handled satisfactorily.

People were supported to access health and social care support from other agencies. Professionals told us the service worked cooperatively with others to help people access healthcare services. People were supported to have enough to eat and drink, and staff told us how they supported people who needed more assistance or encouragement to eat and drink well.

A new manager had commenced work less than one month before our inspection. The service was well supported by the franchise head office, but we identified concerns the service had not been well managed. For example, the service had not consistently implemented learning from previous audits and a number of policies had not been adhered to, such as timescales and frequencies for audits, care reviews, staff supervisions and staff competency and spot checks. Most staff spoke positively about the management of the service which had an open culture. We were also satisfied the new manager understood regulatory requirements and there was a service improvement plan in place when we inspected. We made a recommendation in relation to notifying CQC of incidents in line with requirements.

People were supported to have maximum choice and control of their lives and staff supported /did them in the least restrictive way possible and in their best interests; the policies and systems in the service did not consistently support this practice.

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

Rating at last inspection

This service was registered with us on 22 July 2020 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive 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.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care, safeguarding people from abuse or neglect, staffing and recruitment, consent to care, person-centred care, complaints management, and governance arrangements.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.