Global House Facilities (UK) Ltd

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

During our assessment of this key question, we identified one breach of the regulations. The provider failed to ensure that people using the service received appropriate person-centred care and treatment based on an assessment of their needs and which reflected their personal preferences. The provider failed to ensure that people using the service received appropriate person-centred care and treatment based on an assessment of their needs and which reflected their personal preferences. However, people and their relatives told us, they were involved in assessment of needs and the assessments went well to ensure the care they get is accurate. People and their relatives told us, the provider engaged well with them, staff are well trained and knowledgeable to meet their needs. Staff told us the provider held regular meetings with them.

This service scored 38 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Some people and their relatives told us, they were involved in assessment of needs and the assessments went well to ensure the care they get is accurate. For example, one relative told us, “I feel there was a full assessment of my relatives care needs like personal hygiene on leaving hospital”. “I think the right methods were deployed to ensure the care my relative gets is accurate”. Another relative said, “I feel my relative got the right assessment when he started the service”.

Assessments of people’s care and treatment did not always consider their health, care, wellbeing, and communication needs, to enable them to receive care or treatment that had the best possible outcomes. Assessments were not always up-to-date and reflective of people's needs. There were no clinical and or best practice tools such as the Malnutrition Universal Screening Tool (MUST) referred to and or used in assessing people's individual needs. Care plans were not individualised, nor person centred. For example, care plans continued to fail to identify and reflect individual’s preferences, contain correct information about them and their needs, wishes, emotional and social needs, including those related to any protected characteristics under the Equality Act 2020 and information contained in care plans was contradictory in parts. The care plans for 3 people we looked at all failed to document their personal information, personal history, social networks and needs, wishes, personal preferences, diverse needs and likes and dislikes. One person’s care plan documented that they 'had little capacity due to dementia'. There were no further information or details documented to ensure their needs and preferences were considered and met and no guidance for staff on how best to support them. A second person’s care plan documented that they were receiving one care visit a day and not three and failed to document when the person required support. Their care plan had also misgendered them and referred to them as "he". A third person’s care plan documented they were living with Alzheimer's disease. However, their mental health history stated there were 'no issues detected' and went on to state '[person] is not regularly on alert', with no further information to clarify what this meant, and no details documented to ensure their needs and preferences were considered and met including guidance for staff on how best to support them.

Some people and their relatives told us, the provider engaged well with them, staff are well trained and knowledgeable to meet their needs. One relative told us, “The company is well engaged with our care requirements”. “He has some dietary requirements, but I as relative, will buy the food and the staff will cook it”. “We have no problems with confidentiality and dignity”.

Assessments and care plans did not consider and document people's health and well-being needs to enable them to receive care and or treatment that has the best possible outcomes. Assessments and care plans were not up-to-date and reflective of people's needs including their nutrition and hydration. Where people required support with meal planning and preparation, their care plans did not always identify and document their dietary preferences, cultural needs and associated risks to ensure staff provided them with safe and appropriate care and this required improvement.

The registered manager told us that ‘informal conversations’ with staff were conducted but these were not recorded, and no formal supervisions were conducted. A member of staff told us, “I attend staff meetings through zoom platform online. At least once a month. In the meeting we discuss about any challenges, we face in getting to the service users houses, the use of PPE, and our uniform.” Another member of staff said, “We have staff meetings in the office and discuss what manager want us to know about, any emergency, and trainings to attend.” A third member of staff commented, “We do have a staff platform and we meet every day; every day we talk and interact it is a daily activity.”

There was a lack of systems and tools in place to ensure the provider worked effectively with commissioning partners and to implement a safe and effective handover and transfer of care process ensuring continuity in people's care. Records we looked at and staff we spoke with demonstrated that the provider was not proactive in seeking ways to participate and communicate with commissioning bodies and with health and social care professionals. This assessment of the service was in part conducted due to concerns raised by a commissioning authority. They informed the CQC of 16 missed care visits and late visits to people using the service. The provider had failed to ensure people’s safety and to deliver their care, communicate these concerns to the commissioners, to raise a safeguarding referral to the local authority and to notify CQC of the concerns. There were limited processes in place for reviewing and improving communication internally and with external health and social care partners. There was little evidence of interagency and partnership working, and the provider failed to become involved in practice forums, system meetings, provider support, commissioner quality assurance or communication with other parts of the local system with which the service has links. There were no systems in place to provide staff with appropriate ongoing supervision and support to confirm their competence within their roles was maintained. There were no systems in place to ensure staff received regular appraisals of their performance in their roles from an appropriately skilled and experienced person where any training, learning and development needs could be identified, planned for and supported.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.