ReadyCQC — A weekly field guide to CQC home-care regulation

criticalSafeguarding — “Systems and processes were not established and operated effectively to protect people from the risk of abuse. This placed people at risk of harm. This was a breach of regulation 13.”
criticalGovernance — “Systems and processes had not been established and operated effectively to assess, monitor, and improve the quality and safety of the services provided.”
criticalPerson-centred care — “Visits were scheduled to meet the needs of staffing availability and not people's preferences, which could impact on people's dignity.”
criticalComplaints handling — “One person said, 'If I made a formal complaint, I'd be frightened that they'd pull out of my care and as I like my current regular care worker, I don't want to risk it.'”
criticalStaffing levels — “Sufficient numbers of suitably qualified, competent, skilled and experienced staff were not deployed. This was a breach of regulation 18.”
moderateStaff training — “Practical moving and handling training was out of date for 10 of 25 staff. Staff did not receive specialist training in supporting people with a learning disability and or autistic people.”
moderateMedication management — “There had been no auditing on medicines completed since March 2023. This placed people at the potential risk of not receiving their medicines as prescribed.”
moderateMissed or late visits — “Analysis of a sample of call monitoring data showed 31% of visits were not logged. There was no system or log in place to explain the reason for this.”
moderateCare planning — “People told us they did not always have access to their care plans or involvement in reviews. 'I don't have a care plan as far as I know.'”
moderateIncident learning — “People told us of accidents and incidents which had not been recorded, creating a risk not all potential safeguarding concerns were being identified and escalated appropriately.”
moderateEnd-of-life care — “The service did not consistently engage people in planning their end of life care or demonstrate how they record and act on individual wishes.”
moderateLeadership — “The registered manager was not in the country at the time of the inspection and failed to respond to multiple requests to contact the CQC.”
minorRecord keeping — “The language used to describe people in some care records was not always positive and respectful, including describing people as 'moody' or 'manipulative'.”

Inspection report · 2023-06-08

Framework: KLOE · 15 pages · 79 KB · PDF

Requires improvement

safe: Requires improvementeffective: Goodcaring: Goodresponsive: Requires improvementwell-led: Requires improvement

Golden Hands Home Care Ltd (The Office) was rated Requires Improvement overall at its May 2019 inspection, with ongoing breaches of Regulation 17 due to ineffective governance, unrecognised safeguarding incidents, absent complaints records, and incomplete incident learning systems. Effective and Caring were rated Good, reflecting consistent, kind staff and improved training, but Safe, Responsive, and Well-Led remained Requires Improvement.

Concerns (8)

criticalSafeguarding — “a person who had been in receipt of one to one care had fallen and sustained an injury. This was not recognised within the agency as a safeguarding incident”
criticalGovernance — “the registered manager and the provider did not yet fully understand their regulatory responsibilities...These shortfalls are a continued breach of Regulation 17”
moderateIncident learning — “A record was not maintained of missed calls...Some incidents and accidents were recorded but not all and there was no clear system in place to identify learning.”
moderateComplaints handling — “There was no record of any complaints having been received...We could not see evidence of investigation or that people had been provided with a written outcome”
moderateRecord keeping — “a member of staff had been the subject of concerns but there was no record on their staff file of any concern, statements or outcome.”
moderateMedication management — “care plans did not always document the arrangements in place for PRN or as and when medicines and the circumstances in which staff should administer.”
moderateCare planning — “Moving and handling plans were not specific and did not give staff step by step guidance. One person told us, 'Some [staff] handle you quite roughly as they pull you from side to side.'”
minorInfection control — “staff using PPE during our visits to people in their own home but saw that they did not always change their PPE between tasks which is not good practice.”

Strengths

· People received support from staff who knew them well and stayed for the agreed time, with positive feedback on reliability and continuity of care.
· Improvements had been made to staff recruitment including references and DBS checks.
· Staff received training including induction, shadowing, dementia, first aid and moving and handling.
· Staff had supervision meetings and regular spot checks were undertaken.
· People were supported to eat and drink and access healthcare professionals when needed.

Quality-Statement breakdown (21)

safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Preventing and controlling infectionRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experience

OFFICE

Inspection reports (3)