Date of assessment: 8 April to 2 May 2025. Global caring Gloucester is a care at home service that provides care and support for people in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. At the time of our assessment the service was supporting 40 people with the regulated activity of personal care. The service had made improvements and is no longer in breach of regulations in relation to safe care and treatment and good governance. Comprehensive care and medicine records were in place which reflected people’s care needs and the management of people’s risk. People and those important to them were involved with this process. People reported they mainly received care on time which was based on their individual needs. People’s medicines were managed and administered safely. No concerns were raised about staff’s infection control practices. People were protected from potential abuse and harm as the provider had ensured safeguarding procedures were in place and followed by staff and managers. A training programme was in place to ensure staff had the knowledge and skills to undertake their role. Systems were in place to share important information to the staff team and to ensure staff were supported. The provider’s vision and values focused on strengthening and embedding the improvements which had been made since their last inspection. Improved governance systems had been implemented to monitor the service and drive improvements. The registered manager had made improvements to develop the service to further enhance people’s health and wellbeing. The local authority was monitoring the provider and overseeing the provider's call monitoring systems to ensure they accurately captured the delivered calls. We were not fully assured about the content of feedback from staff.
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Global Caring Gloucester was rated Requires Improvement overall following a focused February 2023 inspection, with breaches of Regulations 12 and 17 identified relating to unsafe risk management, inadequate care planning, and ineffective governance and record-keeping systems. Strengths included safeguarding awareness, infection control, and a responsive provider attitude during the inspection.
Concerns (7)
criticalCare planning: “People's care plans and risk assessments were not always reflective of their current health and well-being needs.”
criticalRecord keeping: “Accurate records had not been maintained for each person and persons employed to carry out the regulated activity.”
criticalGovernance: “Effective monitoring systems did not comprehensively monitor and improve the quality and safety of the service.”
moderateMedication management: “Staff would benefit from further guidance around the management and preferred administration of people's medicines and creams.”
moderateMissed or late visits: “Feedback from some people (and some relatives) and from reviewing the provider's systems indicated that staff were not always punctual.”
moderateIncident learning: “It was not comprehensively clear from the provider's systems whether they had taken action, analysed the incidents for any trends.”
minorSupervision / appraisal: “Some records to be repetitive in parts and did not always explicitly describe the skills and support of each staff member.”
Strengths
· Staff understood the importance of reporting safeguarding concerns and had received safeguarding training.
· Safe infection control practices were in place, reflecting current government guidance, with staff trained and having access to PPE.
· The provider was responsive to inspection feedback and began updating care plans and implementing protocols during the inspection.
· Safe recruitment practices were being used.
· The provider used feedback to drive improvements and lessons were learnt when incidents occurred.
Quality-Statement breakdown (9)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
well-led: Promoting a positive culture; managers and staff clear about roles and quality performanceRequires improvement
well-led: Duty of candour; continuous learning and improving careRequires improvement
well-led: Engaging and involving people, the public and staff; working in partnershipRequires improvement
First inspection of newly registered domiciliary care service rated Good overall, with Good in safe, effective, caring and responsive. Well-led was rated Requires Improvement due to quality monitoring systems not being fully embedded and inconsistent engagement with relatives.
Concerns (3)
moderateGovernance: “The provider and registered manager had systems to monitor the quality of people's care however these were not always fully embedded.”
moderateCommunication with families: “some relatives told us their views had not been sought. One relative had raised some concerns about the service to the local authority, as was not sure who to contact”
moderateLeadership: “the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.”
Strengths
· People felt safe and were protected from abuse, with staff trained in safeguarding.
· Individual risks were assessed with clear guidance for staff.
· Consistent staffing team delivering person-centred care with adequate visit times.
· Medicines managed safely with accurate MAR charts and audits.
· Staff received induction, training and supervision; positive feedback from people and relatives.
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experience
Not rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Engaging and involving people using the service, the public and staff; Continuous learning and improving careNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated
well-led: Working in partnership with othersNot rated