Global House Facilities (UK) Ltd

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

During our assessment of this key question, we identified one breach of the regulations. The provider failed to provide safe effective leadership, governance and to have and maintain robust oversight of the service and its delivery. People and their relatives gave us a mixed feedback about their management. Staff described the leadership at the service as approachable and supportive. Staff told us they worked in partnership with external professionals as required, to achieve positive outcomes for people.

This service scored 39 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Commissioners informed us of the lack of communication from the service and staff. They advised that when they contacted the service staff knew little about their concerns and that people had not received their care. Commissioners wished to know if people had been risk assessed to ensure the most vulnerable people received their care, however, staff were not able to confirm which people were most vulnerable and the commissioners were not confident that staff were knowledgeable with the providers continuity plan.

Risks to people were not always identified, assessed, recorded and managed in a safe manner. Care plans were not individualised, nor person centred. Systems in place for oversight of staff recruitment, training, supervision and appraisal and staff competencies were not robust placing people using the service at risk of receiving unsafe care and support. The provider failed to work within the principles of the MCA to ensure consent to care and treatment was practiced in line with law and guidance. The systems and processes in place for managing and administering people's medicines was not safe. Managers did not always account for the actions, behaviour, and performance of staff. The provider had failed to communicate service failings and concerns to the commissioners, to raise a safeguarding referral to the local authority and to notify CQC of the concerns. There was little evidence of interagency and partnership working, and the provider had 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 actively seek, analyse, and respond to the views of a wide range of stakeholders, including people using the service, staff, professionals, professional bodies, commissioners, local groups, members of the public and other bodies, about their experience of, and the quality of care and treatment delivered by the service. There were audits in place to monitor the quality of service. However, these were not robust enough to identify the issues found during this inspection. For example, the provider audits failed to identify and make improvements in relation to staff deployment, late calls, short calls, doble handed calls, travel time between calls, same staff was shown in 2 different places at the same time.

People and their relatives gave us a mixed feedback about their management. “I have no problem contacting the manager if I needed to, but it hasn’t been necessary”. “I have no complaints about how the company is run”. “There’s nothing I would like to change”. “They cater for my needs”. “I would definitely recommend Global House Facilities (UK) Ltd, because they have been alright with me”. A relative said, “I think the management are very good indeed”. “They know what they are about and hands on”. “I have no problems in contacting them for any specific requirements. The care is in-line with our needs”. However, another relative commented, “The company is hap-hazardly run by management”. “It’s very inconsistent”. “It seems the management are learning as they are doing”. “I would recommend Global House Facilities (UK) Ltd, for the staff, but not so much for management”.

We spoke with the registered manager and were unable to establish and evidence that the service and staff were involved in any practice forums, system meetings, provider support, commissioner quality assurance or communication with other parts of the local system which the service was linked. The service and staff lacked insight and knowledge into this and was not proactive. Staff told us they worked in partnership with external professionals as required, to achieve positive outcomes for people.

Their was mixed feedback from the provider’s current commissioners. Some raised no concerns with the care packages, staff and about the provider, whereas others informed us of a lack of communication and information from the service and staff.

The provider and staff failed to understand their duty to collaborate and work in partnership, to share information and learn and to drive and work together for service improvement. There were no handover processes and systems in place to ensure continuity in people’s care. Commissioned funded packages of care were primarily received from hospital staff as part of people’s health-funded discharge plans. After funded periods ended the provider failed to implement a handover process for people’s care needs and risks ensuring continuity and safety for people’s care. There was little evidence of interagency and system partnership working. The service was not part of any local forums with other providers, social care, health care, commissioning and the local community. This meant that there were no systems and processes to influence, give feedback, share ideas for improvement and to learn from others. There were very limited processes in place for reviewing and improving communication internally and with external health and social care partners. There were no systems and processes in place to seek and gather feedback. The provider failed to implement and conduct customer survey’s however, there was small space within the provider’s staff spot check records for people and their family to provide feedback, but we found very little information had been recorded. Following our on-site assessment of the service the provider sent us 2 completed surveys conducted in 2023. However, no analysis of these were conducted to help drive service improvements and no mechanisms were in place to audit feedback received, learn lessons or to develop the service based on feedback.

The provider and staff failed to understand their duty to collaborate and work in partnership, to share information and learn and to drive and work together for service improvement.

The provider and registered manager did not implement relevant and or mandatory quality frameworks and were not aware of recognised standards and best practices to improve equity in experience and outcomes for people using services and to tackle known inequalities. Systems in place for oversight of staff recruitment, training, supervision and appraisal and staff competencies were not robust and staff recruitment processes did not follow safe recruitment practices with several staff employed without prior care work experience or skills.