Archived: Gateway Care Services

During our inspection we spoke with the provider, team manager, staff trainer, four office staff, seven care workers, ten relatives and eight people who used the service. The service cares and supports approximately 90 service users.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People who used the service were not adequately protected from the risk of abuse. Although people we spoke with told us they felt safe, the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The provider did not follow safeguarding procedures when incidents took place and they did not contact the correct authorities in a timely manner in the event of safeguarding incidents.

Staff we spoke with told us they were trained in safeguarding people and were able to discuss with us the different forms of abuse. However, some staff did not know about the Mental Capacity Act (2005). This meant people might be at unnecessary risk of harm.

Is the service effective?

People's needs were assessed and care and support was planned and delivered in line with their individual care plan. We looked at four people's care and support folders and found people's care needs had been assessed effectively. We found people had risk assessments in place which were reviewed regularly by the service. We spoke with relatives and one told us, "the carers do a good job.' Another told us, 'The quality of the care is good.'

Is the service caring?

Relatives and people who used the service we spoke with were positive about the care provided by their care workers. One relative we spoke with told us, "The care worker is caring and treats my relative with kindness and respect." One person who used the service referred to their care worker as, "my friend." Another person said her care worker was, 'gentle and kind.'

Previous responses from people and relatives on satisfaction surveys indicated the care being provided was good. We saw a recent letter from a relative who praised the care workers and the level of care being provided.

Is the service responsive?

The majority of people and their relatives we spoke with knew how to raise a concern or make a complaint. The service had a complaints folder and also within people's care folders kept at their homes there was a complaint record sheet. We looked at the investigations carried out by the provider for some of the complaints received since our last inspection but this confirmed they had not been completed to a satisfactory conclusion. The provider and manager were unable to tell us the outcome of these complaints and safeguarding incidents. We found no evidence that learning from incidents or investigations had been documented and appropriate changes implemented.

There was no system in place to make sure that the provider, manager and staff learned from events such as accidents and incidents, complaints, concerns and investigations. The provider did not hold regular team meetings and staff we spoke with confirmed they had not attended staff meetings. This meant that people were not benefiting from a service that was taking on board lessons learnt and reviewing and analysing adverse events.

Is the service well-led?

At the time of our inspection the provider had not yet ensured that the manager, who had been in post for six weeks, had applied to become the service's new Registered Manager. This meant the service had not confirmed they had someone to manage the regulated activity. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

The service had a quality assurance system but documents shown to us indicated that a number of the shortfalls identified from the monitoring process had not been addressed. For example, there had not been full investigations into recent concerns about missed and late visits by care workers, notification of lost data, safeguarding incidents and concerns relating to staff training.

At our visit we found that people and relatives were involved in the care and there were appropriate measures in place to ensure only suitable people were recruited for the job. People received safe care that met their needs. Staff were suitably supported in their job and quality assurance checks were now mostly in place.

People were protected from the risk of abuse and received care that was safe. Staff received appropriate training and were supported suitably in delivering care to people.