Archived: Goldsborough - Maldon

Updated 23 September 2016

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.

We undertook an announced inspection on the 5 July which included another visit on 29 July and we further followed up information until 8 August 2016. The provider was given 36 hours’ notice of our two visits because the location provided a domiciliary care service and we needed to be sure that someone would be in.

In May 2016, the Provider had taken on the contract from another provider to run a reablement service. People who used the service and staff had been transferred to its base at Goldsborough Maldon.

At the time of our first inspection visit, we were told by the acting branch manager that the reablement service was not part of Goldsborough Maldon so we did not inspect this service at that time. After communication with the provider, it was established that the service was being provided by Goldsborough Maldon and an inspection of this service was undertaken.

Our first visit to the domiciliary care service included one inspector, a member of the CQC medicines team and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who has used a domiciliary care service. The inspection of the reablement service was completed by one inspector.

Before the inspection we reviewed the information we held about the service including any safeguarding concerns and statutory notifications. Statutory notifications include information about important events which the provider is required to send us by law.

On the days of the inspection we spoke with the acting branch manager, acting manager and an operations officer at their office location. We reviewed 19 people’s care records, 13 staff recruitment and training files and looked at quality audit records. After the office inspection, we went to visit three people at their homes and made phone calls to 46 people who used the service. We also spoke with 15 staff members and two social care professionals.

Updated 23 September 2016

We carried out an announced inspection of the service on 5 July and 29 July and we further followed up information until 8 August 2016.

Goldsborough Maldon provides a domiciliary care and reablement service to people in their own homes. The domiciliary care service provided care and support to 151 people and 74 staff supporting them. The reablement service provided care and support to 324 people with 106 staff supporting them and had started operating in May 2016.

A registered manager was registered with CQC to manage the domiciliary care service but was on maternity leave during the time of our inspection. The provider had put in place an acting branch manager to oversee the management of the domiciliary care service and an acting manager for the reablement service. The post of registered manager for the reablement service was in the process of being filled. 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.

The service did not have appropriate systems in place to keep people safe. Risks to people’s health and wellbeing were assessed but not managed effectively to keep them safe and there were insufficient numbers of staff available to meet people’s needs.

Systems were not in place to ensure people received their medicines safely and in a timely way because missed calls and late or early calls were putting people at risk of not receiving their essential medicines.

A supervision and appraisal process including competency checks for staff in carrying out their role was in place but was not consistent across both services.

People were not receiving support and assistance with their nutritional or hydration needs as staff were not turning up within a specified time or calls were being missed completely. People could not be assured that they would receive their necessary drinks and meals as part of their planned arrangements for care.

The service was not always courteous and respectful to people who used it. People did not know when the service was being provided and by whom and they did not receive the service at a time of their choosing. This did not always show the service was caring.

The service was not responding appropriately to people’s needs. People were receiving less than an acceptable level of service as they were being left without essential care and support.

Whilst complaints and concerns were being logged, the management had not acted on the information about the quality of care people had received or looked at how people’s concerns could be used as an opportunity to improve both of the services provided.

Some quality assurance systems were in place but were not being used monitor and evaluate the service effectively to provide a high quality service.

There was no visible leadership in the service or clear vision or values. The management arrangements were in state of disarray as there were significant changes going on with the location. However, the provider had started to make improvements to the service to keep people safe.

Care and support plans were sufficiently detailed and provided an accurate description of people’s care and support needs. Staff had most of the right information, skills and knowledge to provide care and support to people.

A recruitment process was in place to protect people and staff had been recruited safely.

Staff told us that they were mostly supported in their role and received encouragement to do their job well.

Staff understood people’s needs and provided care and support accordingly. People were treated with compassion and kindness by staff who provided their care.

You can see what action we told the provider to take at the back of the full version of the report.