Background to this inspection
Updated
11 May 2019
The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.
Inspection team: This consisted of one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. They contacted people during the inspection to find out about their experiences of using the service.
Service and service type: GTG Care Nursing is a domiciliary care agency. It provides personal care to people living in their own homes in the community.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: We gave the provider 48 hours' notice because we needed to ensure somebody would be available to assist us with the inspection. We inspected this service between the 27 and 29 March 2019. This included a visit to the office location.
What we did: Before our inspection visit, the provider completed a Provider Information Return (PIR) is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed information we held about the service in the form of statutory notifications received from the service and any safeguarding or whistleblowing incidents, which may have occurred. A statutory notification is information about important events, which the provider is required to send us by law. We used all this information to plan our inspection.
During the inspection, we contacted five people using the service and two relatives to get their feedback. We also spoke with nine staff members. This included the registered manager, the team leader and eight care staff. We reviewed a range of records. This included four people’s care records, staff records, audits and records related to the management of the service.
Updated
11 May 2019
What life is like for people using this service:
• Improvements were needed in how the provider assessed risks to people as there were inconsistencies across the records we reviewed. Although people told us that they did not have any concerns with how they were supported with their medicines, we saw that improvement was needed to ensure practice was in line with the National Institute for Health and Care Excellence guidance.
• People told us that they felt safe using the service and staff were confident that any concerns would be dealt with appropriately. The provider had a new electronic call monitoring system where staff logged in and out of their calls, which enabled care staff visits and punctuality to be monitored. Staff followed infection control guidance and had access to personal protective equipment.
• Care staff had the skills, knowledge and support required to meet people’s needs.
• People received support from care staff that were of a caring nature. The majority of people who used the service told us that staff were kind and caring and treated them with dignity and respect. People had regular care staff who knew how they liked to be supported.
• People consent was sought before staff provided care and staff understood the principles of the Mental Capacity Act. The provider had a system in place for responding to complaints. People knew how to complain however were not always confident their concerns would be acted upon.
• People and their relatives were generally satisfied with the service they received however we found that the service was not consistently well led. The systems in place to assure the safety, quality and consistency of the service were not consistently effective.
• This is the third consecutive inspection whereby the provider had failed to achieve an overall ‘Good’ rating.
We found a breach of regulation in relation to the systems in place to monitor and improve the quality of the service. You can see what action we told the provider to take at the end of the full version of this report.
More information is in Detailed Findings below.
Rating at last inspection: Requires Improvement (report published 3 October 2017 ).
About the service: GTG Care Nursing is a domiciliary care agency. It provides personal care to people living in their own homes in the community. At the time of the inspection they were supporting nine people, however not everyone was receiving the regulated activity of personal care. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
Why we inspected: This was a planned inspection based on the rating at the last inspection.
Follow up: We will ask the provider following this report being published to tell us how they will make changes to ensure they improve the rating of the service to at least Good. We will revisit the service in the future to check if improvements have been made.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk