Goldcrest Heathcare Service (Birmingham)

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

Staff had received training in safeguarding and knew how to report any safeguarding concerns. Concerns raised by staff were mostly documented to ensure there was a record of appropriate action taken to keep people safe. Risk assessments and management plans were in place and risks to people's safety and well-being were managed through a risk management process. People had comprehensive positive behaviour plans which guided staff on how to support people safely. People received care and support in line with their needs. Staff felt they had adequate training around medicines and regular checks of staff abilities were conducted. Medicines protocols were in place.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives told us that since the new management structure had been in place they were confident any concerns raised would be dealt with. One relative told us, “I have met some lovely, respectful carers from Goldcrest Healthcare, and I have a fantastic relationship with the manager, we have worked together to get [name of service user] settled. If I need anything answered I know who to contact and I feel confident any questions or complaints would be dealt with satisfactorily.” Other relatives said the provider had responded to them in a timely way.

The management team told us that they monitored and reviewed accidents and incidents, these were also recorded and discussed during staff meetings. Staff demonstrated they understood their roles and responsibilities to record and report accidents and incidents. Lessons learned following incidents were also discussed through supervisions and staff meetings.

Systems were in place to report, record and monitor incidents and accidents. However, further improvement was required in relation to how these were recorded and reported. For example, we found a complaint where a relative contacted the service following an incident involving their loved one. This complaint was investigated, but only because the relative had complained. The staff had not recorded and reported the incident immediately after it had occurred. It was also not always clear from accident and incident records that all the relevant action had been taken following an incident. Effective systems were not in place to ensure notifiable incidents were consistently reported to us. This was raised with the registered manager who took action after the inspection to change record templates so that the process was much clearer for staff to follow. The provider had systems in place to ensure lessons learnt were shared with staff and, when appropriate, other services operated by the provider.

People told us the staff met their needs to ensure a safe transition from hospital, a different care provider, or when accessing health services. One family member told us, “The carers get [name of service user] ready for hospital appointments”. People told us their care plans were updated to reflect their changing needs.

Staff told us they ensured people were involved in discussions about their care needs and followed their care plans and risk assessments. One staff member told us, “We talk to people and their relatives to get to know their preferences. It is also recorded on the person’s care plan.”

Partner agencies told us the provider had successfully worked with them and had been involved in discussions with them about people’s care needs.

The provider had processes to monitor safe systems, pathways and transitions. This included a comprehensive needs assessment which was completed prior to support being provided.

People told us they felt safe with staff and spoke positively about them. One family member told us, “I am happy with Goldcrest and I feel [Name of service user] is safe with the carers. If I have a concern, I call them and they respond immediately, the communication is good, if I can’t speak to who I need to they will get back to me as soon as possible.”

Staff described their responsibilities in relation to safeguarding and told us how they would report any concerns to the relevant agencies as required. Staff told us they had completed safeguarding training and were aware of the different types of abuse and reporting procedures to follow if they had any concerns of abuse. One member of staff said, “There can be different types of abuse such as physical, emotional and financial”. Another staff member told us, “If I witnessed abuse, I would make sure the person was safe. I would report the incident to my manager. If I was unhappy with how the incident was managed, I would contact the safeguarding local authority, the Police and CQC”

The provider had a detailed safeguarding policy and procedure for staff to follow. There were systems and processes in place to report and record safeguarding concerns. The registered manager and provider understood their responsibility under the duty of candour and took responsibility when things went wrong. Records showed safeguarding concerns were investigated which involved people, relatives and other healthcare professionals including the local safeguarding teams. To protect people’s safety and welfare, risk assessments were put in place detailing measures to mitigate further risk to people.

People and relatives told us staff understood their needs and provided the support they needed to stay safe from harm . A relative told us, “[Name of service user] is definitely safe. They have 1 regular carer that comes who they have a really good bond with. Their cognitive impairment can result in them displaying distressing behaviour. As soon as that carer comes [name of service user] is listening and does things. They know how to communicate with “[Name of service user]. Sometimes we are struggling to get [Name of service user] to eat and drink. As soon as the carer comes, they get [Name of service user] to do it”.

Staff demonstrated they were aware of people’s individual needs and helped ensure people were safe. They told us that risk assessments provided guidance on what action they should take to reduce risks and maintain people’s safety. Staff were encouraged to report new risks so that appropriate action could be taken to ensure the safety of people. A staff member told us, “We keep people safe without taking away their independence, there are tasks that some people like to do for themselves.”

Effective systems were in place to ensure risks to people’s health and safety were assessed and person-centred care plans were implemented. People assessed as needing a specific number of staff to support them safely received this level of support. Where required, care plans included guidance and strategies for staff on people’s individual warning signs and how to manage distress in a person-centred way. For example, staff were guided to use distraction and redirection strategies to support a person who experienced distress.

People told us staff used their prescribed equipment to promote their safety and wellbeing.

Staff received a range of training to support them to keep people safe. The provider told us they monitored and reduced environmental risks and staff had received a range of training to support them to keep people safe.

There were systems in place to monitor the safety and upkeep of the environment and equipment. Regular checks were completed by the provider to ensure the environment and equipment was safe for people to use. This included checks for fire safety, and moving and handling equipment.

People and relatives told us that staff knowledge and skills had improved since the new registered manager had been in post and specialised training was provided. One person told us, “The carers give time for me to try and lift myself.” A relative told us, “We are happy with the hoisting of [name of service user]. There have been no accidents.” People also told us they were supported by staff that knew their needs well. When possible, staff members would support the same people to promote stability and continuity. A person told us, “I feel safe. To be quite honest I have been with them for 3 or 4 years and I have had no problems. They are caring. I don’t feel as if I am being rushed especially in the morning as I am not very good.” A relative told us, “[Name of service user} is definitely safe. They get on really well with the carers that come. They make them laugh.”

Staff told us they felt supported and spoke positively about working for the service. A staff member told us, “Since the new manager has in post, the service has improved, and the communication now is much better”. Staff told us they worked well as a team and shared information with each other, as necessary, to ensure effective care was consistently provided. Staff told us they felt very supported by their team managers who were there for them when needed. One staff member told us, “The care managers and seniors are supportive and approachable”. Staff provided safe and effective care to people. Staff received an induction and regular training which included mandatory training. A staff member told us, “The training is much better now, we have online and face to face”. Another staff member told us, “During my induction, I shadowed an experienced team member for 3 days and completed training. After my induction, I felt comfortable to support people on my own however I was given the option of extending my induction if I didn’t feel ready”. Supervision and appraisals were in place to monitor performance and development. Staff participated in monthly staff meetings where they were able to share information and receive important updates about the service.

The service ensured staff had the knowledge and skills required to meet people’s needs. The provider followed safe recruitment practices and had ensured appropriate pre-employment checks were completed satisfactorily before staff were employed.

Feedback from people and their relatives was positive regarding cleanliness and infection prevention and control. One person told us, “The carers wear PPE and always clean up afterwards.” A relative told us, “The carers always wear gloves. I always make sure they are clean as [name of service user] is at high risk.”

Staff told us they received training in infection prevention and control and were aware of safe hygiene practices. No concerns were raised about the availability of Personal Protective Equipment (PPE).

The provider had effective policies and procedures in place regarding infection prevention and control. The provider knew how to respond to risks and signs of infection and how to make sure infection outbreaks at the service would be effectively prevented or managed.

We received mixed feedback people about medicine management. People told us they received their medicines as prescribed. However, 1 relative told us, “There have been a couple of hiccups. Sometimes [name of service user] has been on medication and when I’ve gone away and come back the medication doesn’t tally up.” Another relative told us, “They make sure [name of service user] has their medication every morning, no problems.”

Staff informed us they received training in the safe handling of medicines and had their competencies checked on a regular basis. One staff member said, “We receive training in medicine management and our competencies are checked.”

Improvements were needed to ensure medicines were consistently managed safely. For example, the care and medication records for people who received their medicines in a blister pack did not always record the details of the medicines prescribed for the individual. If there were any issues with a person’s medicines such as an overdose or missed medication, it is important for staff to know what is contained in the blister pack so the appropriate action can be taken. In addition, it was not always clear from care records how people were receiving their medicines.