Golden World Care Service

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Based on the findings of this assessment we found the service had improved and addressed all the outstanding breaches we identified at their last inspection. This meant people were now kept safe and protected from avoidable harm. We have therefore changed the providers rating for this key question from requires improvement to good. This was because the provider had followed the action plan they had developed after their last inspection and improved how they now protected people from abuse, assessed and managed risk, prevented and controlled infection, trained staff and managed medicines. In addition, people continued to receive continuity of care from a dedicated group of competent, well-supported staff who were familiar with their individual care needs, wishes and daily routines.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us the provider learnt lessons when things went wrong and acknowledged when they could and should have done better.

Managers and staff told us incidents and accidents, and safeguarding concerns involving the people they supported were always logged and analysed. These incidents were routinely reviewed to determine potential causes and to identify any actions they needed to take to reduce the likelihood of similar incidents reoccurring. Care staff confirmed information about any lessons learnt were always shared with them during individual and group supervision meetings with their line managers and fellow co-workers.

The provider learnt lessons when things went wrong. The office-based managers and senior staff continually reviewed incidents and accidents, and safeguarding concerns to determine potential causes and identify any actions they needed to take to reduce the likelihood of reoccurrence and learn lessons, so they could continually improve. This information was shared and discussed with staff during individual and group meetings.

People told us they were invited to participate in an assessment process prior to them receiving a home care service from this provider. People told us they received the personal care and support that was planned in accordance with their assessed needs and wishes.

Managers told us people's personal care needs were assessed before they were offered the opportunity to receive a service from this provider. Managers confirmed these initial assessments were used to help staff develop person-centred care plans for everyone they supported.

External health and social care professionals told us the provider collaborated with them to establish and maintain safe systems of care.

People’s care plans were based on assessments conducted by the provider and various external health and social care professionals. These care plans included detailed information for staff about how to support people with their personal care and support needs. We saw care plans had been developed for everyone currently receiving a service from this provider.

People told us they felt safe with the staff who regularly supported them with their personal care. A person said, “I do feel safe with my regular carers."

Managers supported staff to protect people from abuse. Staff received safeguarding adults training as part of their induction which staff confirmed remained up to date because it was routinely refreshed. Staff knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A member of staff told us, “Yes, I am aware there are different types of abuse and neglect and what they all are. I also understand it’s my responsibility to report any suspicions I might have that people are being abused by anyone immediately to the managers in the office.” Another member of staff added, “I would report any concerns that came to my attention to my supervisor/manager who I am confident would report it to the right local authority.” Staff were routinely reminded about their safeguarding roles and responsibilities at individual and group meetings with managers and co-workers. The office-based managers understood their legal responsibility to immediately refer any safeguarding incidents or concerns to external agencies and bodies including, the relevant local authority, the CQC, and where necessary, the police.

Robust systems and processes were now in place to protect people from the risk of abuse. The provider had clear safeguarding policies and procedures in place which were up to date, in line with relevant legislation and accessible to all. The provider had a staff ‘Speak up/Whistle blowing policy in place. Whistleblowing is the term used when a worker passes on information concerning perceived wrongdoing, typically witnessed at work. Managers worked well with external agencies, such as local authorities and the CQC, and acted in a timely way to ensure people were safeguarded and protected from further risk.

People told us care staff knew how to support them in a safe way to prevent and/or minimise the risks they might face. A person said, “My regular carers know what they’re doing and how to look after me and keep me safe.”

Care staff were aware of people's daily routines, preferences and needs, and knew what action they needed to take to reduce or safely manage risks people they supported might face. A member of staff told us, “I always follow peoples personalised care plans closely, use proper moving and handling techniques, and ensure the people I support who are at risk of developing pressures sores are always positioned correctly to prevent them.” Another member of staff added, “For people whose behaviours can become distressed sometimes I read up about the persons history, preferences and what might trigger their distress from their care plan. I then try and tailor the personal care I give them to try to prevent or minimise that distress.”

People's care plans contained most of the up to date risk assessments and management plans they required to ensure staff had access to all the information and guidance they needed to prevent or safely manage risks people they supported might face. They included, for example, risks associated with infection control, safe management of medicines, falls prevention, nutrition, supporting people living with dementia and preventing and/or managing pressure sores. Most of these risk assessments and management plans had been regularly reviewed and updated accordingly to reflect people's changing needs. However, despite these improvements, some risk assessments and management plans associated with the health and safety of people’s home environment and mobility needs were either not being kept up to date or could not be found on the first day of our inspection. We discussed this issue with the provider at the time of our assessment. They responded immediately and were able to provide us with additional evidence on the last day of our inspection to show us peoples risk assessments and management plans were now all up to date and immediately accessible on request. This meant staff now had access to sufficiently detailed and up to date guidance they required to prevent and/or safely manage risks people they supported might face.

People told us staff from the office routinely came to visit them at home to check the equipment staff used to support them, such as mobile hoists, remained in good working order and fit for purpose.

Staff confirmed the office-based managers and senior staff routinely visited people in their homes to check the equipment they used remained in good working order and fit for purpose.

The equipment staff used, such as mobile hoists, were routinely risk assessed by the office-based managers and senior staff.

People told us staff who supported them never missed their scheduled call visits and were usually on time. A person said, “Staff come on time,” while another person added, “Staff are always bang on time.” People also said staff stayed and completed all the tasks they were supposed to as set out in their care plan. A person remarked, “Staff always do what they are supposed to do.” A second person added, “Yes, they [staff] stay as long as they should and complete everything they said they would.” Furthermore, people told us they received continuity of care from a regular group of care staff who were familiar with their personal care needs, preferences and daily routines. A person said, “I do have the same 2 regular carers who I have got to know really well.” A relative added, “We have a regular team of 5 care staff and an additional person that covers holidays, so my [family member] knows them all.” People were also positive about staffs knowledge and skills and said they were always kind and friendly. A relative told us, “Our regular core team of carers are well trained and in general they all know what they need to do for my [family member].”

Staff reported that their call visits were well-coordinated by the office-based managers. One staff member said, “The office schedules my calls so I have enough time to travel between visits. Most of my calls are grouped for clients in the same area, reducing travel time.” Another staff member added, “My visits are well-coordinated, and most of the time we have enough time to complete our tasks.” Staff also noted they had a dedicated group of people they regularly supported, with managers making efforts to assign clients living close to one another, minimising travel demands. A staff member stated, “The managers try to assign the same carers to individuals to build trust. This consistency allows us to understand each person’s preferences and provide more personalised care.” Another staff member added, “The same staff are assigned to clients, ensuring continuity. This consistency helps us build relationships and better understand their needs and preferences.” Staff training was relevant and routinely updated to ensure skills remained current, including dementia awareness training within the last 12 months. Staff demonstrated a strong understanding of their roles and responsibilities, with one saying, “I’ve received all the necessary training, including induction and regular refreshers in moving and handling, safeguarding, infection control, and safe medicines management. The training equips me to perform effectively.” Staff also had ongoing opportunities to reflect on practice and identify any additional training needs through regular individual and group supervision sessions. One staff member confirmed, “I receive regular supervisions, individually and in groups. These sessions provide valuable feedback and allow me to discuss any concerns or areas for development.”

Most pre-employment checks the provider is expected to carry out for all new staff were made available on request during this inspection. This included staff’s proof of identity, their right to work in the UK and a satisfactory Disclosure and Barring Service (DBS) check. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. However, while most staff files contained at least one satisfactory character and/or employment reference for everyone the provider employed, several did not include a second reference. This ran contrary to recognised best staff recruitment practice and the providers own staff employment policies and procedures. The provider responded immediately to this failure after our first site visit and were able to provide us with a satisfactory second reference for everyone they employed by the last day of this inspection. Training records showed us staff attended relevant courses to support them to meet a range of people’s needs. Training was refreshed at regular intervals so that staff stayed up to date with recognised best care practice. The training of new staff included a comprehensive induction programme, which was mapped to the Care Certificate. The Care Certificate is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in health and social care sectors. It is made up of 15 minimum standards that should form part of a robust induction programme. New staff shadowed more experienced ones as part of their induction.

People told us staff always wore personal protective equipment [PPE] when they supported them with their personal care. A person said, “Yes, staff do wear PPE and a uniform when they come visit me at home.”

Managers and staff told us they had received up to date infection control and food hygiene training. A member of staff said, “The company manages infection control and COVID-19 protocols well. I have always had enough [PPE], such as masks, gloves, and sanitizer. Regular testing has been provided, and there has been strong encouragement to get vaccinated against COVID-19.”

The provider now followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. The provider had put a COVID-19 policy in place for people receiving a home care service from them and staff as we had required them to do at their last inspection. In addition, the provider had now conducted individual COVID-19 risk assessments for people receiving a service from them and staff.

People who received assistance from staff to help them manage their medicines told us staff always ensured they took their prescribed medicines as and when they should. A person said, “The staff give me my medicines on time.” A relative added, “They [staff] are very careful about making sure my [family member] takes their medicines when they should.”

Staff were clear about their roles and responsibilities in relation to the safe management of medicines. All staff had received medicines training as part of their induction and their competency to continue managing medicines safely was assessed by managers at least annually or more frequently if required.

Medicines systems were now well-organised, and people received their medicines as and when they should. People’s care plans now included more detailed guidance for staff about their prescribed medicines and how they needed and preferred them to be administered. In addition, none of the medicines risk management plans we looked at contained contradictory, out of date or incorrect information, which had been identified as a concern at the providers last inspection. Medicines were regularly audited by the office-based managers and supervisors observed how care staff managed medicines during their scheduled call visits as part of the providers monitoring of staffs working practices. The provider was also in the process of introducing an electronic medicines system which they planned to be fully operational by the end of October 2024. The new electronic medicines administration records [eMAR] would automatically notify the office-based managers and staff about the occurrence of any medicines errors in real time allowing them to take immediate action to address the issue. We found no recording errors or omissions on any of the medicines administration records sheets we looked at during this assessment.