Archived: Gray Healthcare

Updated 29 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection.

The inspection took place on 4 December 2017. Additional telephone calls were made to people using the service on 7 December 2017. The inspection was announced. We gave the service 48 hours’ notice of the inspection visit because the location provides a domiciliary care service for adults who are often out during the day. We needed to be sure that they would be in.

The inspection was conducted by an adult social care inspector and an assistant inspector.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We checked the information that we held about the service and the service provider. This included statutory notifications sent to us by the registered manager about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We used all of this information to plan how the inspection should be conducted.

We spoke with people using the services, their relatives, health and social care professionals, staff and the registered manager. We also spent time looking at records, including four care records, five staff files, medication administration record (MAR) sheets, staff training plans, complaints and other records relating to the management of the service.

During our inspection we spoke with two people using the service and two relatives. We spoke with four support workers, the owner, the head of operations and other members of the senior management team.

Updated 29 December 2017

Gray Healthcare is a domiciliary care agency that provides support to people with mental health conditions and complex needs in their own homes and communities. Care and support is delivered in a number of geographically dispersed locations across England and managed from a central office in Liverpool. At the time of the inspection 22 people were using the service across five different local authority areas.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good.

The service met all relevant fundamental standards.

A registered manager was not in post. The registered manager had recently left the service. A replacement manager had been offered the position and was due to start in December 2017. Day to day management of the service was being provided by the head of operations and other members of the senior management team.

At the last inspection we identified that records relating to recruitment and training did not consistently demonstrate that staff had the right knowledge and skills to provide safe, effective care. As part of this inspection we checked staff records to see if practice had improved. Each of the records that we saw demonstrated that practice had improved since the previous inspection.

The service maintained effective systems to safeguard people from abuse and individual risk was fully assessed and reviewed.

Medicines were safely stored and administered in accordance with best-practice and people’s individual preferences. Staff were trained in administration. The records that we saw indicated that medicines were administered correctly and were subject to regular audit.

We saw evidence that the service learned from incidents and issues identified during audits. Records were extremely detailed and showed evidence of review by senior managers.

People’s needs were assessed and recorded to a high standard by suitably qualified and experienced staff. Care and support were delivered in line with current legislation and best-practice.

The service ensured that staff were trained to a high standard in appropriate subjects. This training was subject to regular review to ensure that staff were equipped to provide safe, effective care and support.

We saw clear evidence of staff working effectively both internally and externally to deliver positive outcomes for people. For example, senior staff were part of regular multi-disciplinary team meetings which assessed and reviewed the care and support needs for people with complex needs and behaviours.

People were supported by staff to maintain their health and wellbeing through access to a wide range of community healthcare services and specialists as required. We saw evidence in care records of appointments with GP’s, opticians and dentists.

The service operated in accordance with the principles of the Mental Capacity Act 2005 (MCA).

People told us that staff treated them with kindness and respect. It was clear from care and incident records that staff were vigilant in monitoring people’s moods and behaviours and provided care in accordance with people’s needs.

Staff were clear about the need to support people’s rights and needs regarding equality and diversity. Care records contained important information about people’s sexuality, ethnicity, gender and other protected characteristics.

People had individual models of support that suited their personal preferences and goals. We saw evidence that staff had been successful in supporting people to achieve these goals.

The service was making increasing use of technology to aid communication. Each staff team had access to a smart phone and tablet on which they could access, update and share information.

We checked the records in relation to concerns and complaints. The complaints’ process was understood by the people that we spoke with. We saw evidence that complaints had been responded to in a professional and timely manner by a senior manager.

People spoke positively about the management of the service and the approachability of senior staff.

Gray Healthcare had an extensive performance framework which assessed safety and quality in a number of key areas. The performance framework was appropriately matched to regulation and the fundamental standards. Policies and procedures provided guidance to staff regarding expectations and performance.

People using the service and staff were actively involved in discussions about the service and were asked to share their views. This was achieved through telephone contact and regular surveys. The most recent survey yielded a very positive response.

We saw evidence that the service worked effectively with other health and social care agencies to achieve better outcomes for people and improve quality and safety. The professionals that we contacted did not express any concerns about the quality and effectiveness of these relationships.

Further information is in the detailed findings below