Archived: Grace Homecare LTD

Grace Homecare LTD is a domiciliary care agency providing personal care and support to people in their own homes. It provides a service to older people and younger adults. At the time of inspection, the service was providing personal care to 71 people.

People's experience of using this service and what we found

Medicines were not managed safely. The registered manager and provider acted at the time of the inspection to improve medicines records and the policy and procedure regarding safe management of medicines. However, the new records had not been fully introduced and staff were yet to be provided with training in their use.

Quality assurances processes were not robust enough. They had not been effective in identifying concerns found during this inspection relating to medicines, risk, training and care planning. Policies and procedures were not always up to date to reflect good practice guidance.

Staff did not always receive relevant training as identified by the provider’s policies. We have made a recommendation about staff training. Records did not clearly show how risk was managed. We have made a recommendation about the safe management of risk.

People said the care and support provided was safe. The provider had systems in place for responding to allegations of abuse. Overall, staff were knowledgeable about their responsibility in this area. Some staff were not aware of how to report concerns outside of the agency. Staff recruitment checks ensured staff were suitable to work with vulnerable people.

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 supported this practice. People were involved in making decisions about their care and support needs. Staff showed a good awareness of respecting people’s choices and ensuring they had people’s consent to care.

People received care from staff who were kind, and who respected their privacy and dignity. People’s independence was also encouraged. People or their relatives contributed in planning their care and knew how to raise any concerns they may have. Care records were not always detailed or up to date. We have made a recommendation about care plans.

People and staff spoke positively about the registered manager and provider and told us they found them approachable. The provider and registered manager worked with other agencies to ensure people received the appropriate care and support. This included health professionals.

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 27 July 2017).

Why we inspected

This was a planned inspection.

Follow up

We have asked the provider to send us an action plan telling us what steps they are to take to make the improvements needed. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a 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.

This was the first inspection of the service at this location. The registered provider had moved offices since our last inspection visit. At this inspection visit we found all fundamental standards had been met.

People spoke extremely positively about the quality of service provision on offer. Staff were described as caring and kind. People valued the relationships they had developed with their staff team. We saw evidence of staff going the extra mile to help people become independent and autonomous.

People told us they felt safe and secure. Arrangements were in place to protect people from risk of abuse. Staff had knowledge of safeguarding procedures and were aware of their responsibilities for reporting any concerns.

People told us that on the whole, staffing levels and staff reliability were good. We spoke the registered manager and registered provider about staffing. They told us they were proactively looking at ways to retain staff to ensure staff continuity. People who had regular carers told they had developed positive relationships with staff.

Staff told us Grace Homecare LTD was a good place to work. They praised the management and the way in which the service was run. They told us communication was good and described the managers as caring and approachable.

Staff were positive about ways in which the service was managed. Staff described the working culture as positive.

Recruitment procedures were in place to ensure checks were made on staff prior to them starting work. This allowed the service to check people’s suitability for working with vulnerable people.

Suitable arrangements were in place for managing and administering medicines for people who required support with this.

Care plans were in place for people who used the service. Care plans covered support needs and personal wishes. Plans were reviewed and updated at regular intervals and information was sought from appropriate professionals as and when required. The service had systems in place to monitor and manage risks.

People’s healthcare needs were met by the service. We saw evidence of partnership working with other healthcare professionals. When people required support with eating and drinking we saw that appropriate records were maintained.

People told us staff were appropriately trained to carry out their role. Staff praised the training on offer. They told us it enabled them to carry out their tasks proficiently.

Staff who worked for the service had an understanding of the Mental Capacity Act and were able to transfer the knowledge to their practice. When people lacked capacity the service worked with other professionals to ensure capacity was assessed and appropriate systems were implemented.

People told us that whenever they had concerns and complaints they felt they could discuss them with the senior management team and were assured they would be dealt with efficiently and effectively.