17 February 2020
During a routine inspection
Georgina House is a domiciliary care agency that provides care and support to people living in their own homes. At the time of this inspection the service was providing support to 19 people.
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
Lack of governance systems and knowledge of regulatory requirements had meant people who used the service were at risk of receiving care not of the expected quality. Lack of audits had meant the provider was unaware of most of the concerns we identified at this inspection. Where they were aware of poor visit call times, there had been a delay in rectifying this and was ongoing at the time of this inspection. The provider had failed to notify CQC of specified events they are required to by law. At the time of the inspection, the provider had also failed to display the rating from their last inspection on their website; this was rectified shortly after this inspection.
People did not receive a rota so was unaware of which staff would be supporting them and when. Call times for people varied considerably and this meant people were unable to plan their day. Not enough staff were adequately deployed to ensure people received calls at the same specified time each day and this caused them anxiety. Robust checks on staff’s suitability for the role were not in place. Some incidents had occurred which put people at risk and the provider had not reported these to the appropriate stakeholders including the local authority’s safeguarding team. The processes the provider had in place to help protect people from the risk of abuse were not fully effective.
People’s needs had not been assessed in a holistic manner and not all their needs and associated risks had been planned for. Formal reviews of people’s care needs and the service they received were not in place. However, due to people being supported by a small and stable staff team, their personal and emotional needs were met as staff knew them well. 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 and people told us this.
People’s nutritional and healthcare needs were met, and they received their medicines as prescribed. They were protected from the risk of infectious diseases and received information in accessible formats. Staff treated people with respect and kindness, maintained their dignity and encouraged their independence. A complaints policy was in place in the events concerns were raised.
Staff felt supported and morale was good amongst the staff. They received regular supervisions and attended regular meetings which were open arenas for discussion, sharing information and testing knowledge. Mandatory training was not up to date. However, people told us staff were effective and they received a variety of additional training; all had qualifications in health and social care. The service worked with other agencies to meet people’s individual needs.
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 (report published 26 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
At this inspection we have identified breaches in relation to staffing, governance, safeguarding and notifying CQC of specified events.
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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.