Our view of the service Global House Facilities (UK) Ltd is a domiciliary care service providing personal care to people living within the local communities within their own homes. At the time of our inspection there were eight people using the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. We carried out an on-site assessment on 19 February 2024 and an off-site assessment commencing on 19 February 2024 and ending on 22 February 2024. We looked at 13 quality statements: covering safe, effective, responsive and well-led domains. At this assessment we found the provider had not addressed concerns identified at the service’s last inspection that related to ensure consent to care and treatment was practiced in line with law and guidance. People were not always protected from the risk of abuse or harm. The systems and processes in place for managing and administering people's medicines was not safe. The provider failed to ensure there were systems in place which provided safe and effective staffing. People using the service have not received appropriate person-centred care and treatment based on an assessment of their needs and which reflected their personal preferences. Not enough improvement had been made to provide safe effective leadership, governance and to have and maintain robust oversight of the service and its delivery.
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First inspection of this newly registered domiciliary care service identified breaches of Regulations 9, 12 and 17 relating to person-centred care, safe management of risk and medicines, and good governance. Despite caring and compassionate staff, weaknesses in care planning, medicines systems, visit timing consistency and quality oversight resulted in an overall rating of Requires Improvement.
Concerns (8)
criticalCare planning: “Risks to people were not always identified, assessed and recorded and staff did not always have access to risk management information”
criticalMedication management: “People who required support to manage their medicines did not have a medicines care plan, risk assessment or medicines administration records (MAR) in place”
criticalPerson-centred care: “care plans did not always identify and or reflect individual preferences in the way people wished to be supported or contain correct information about their needs”
criticalGovernance: “Systems and processes in place for monitoring the quality and safety of the service were not always effective in identifying issues or concerns”
moderateStaff competency: “medicines competency assessments had not been completed to ensure staff were competent to manage and administer medicines safely”
moderateMissed or late visits: “the gap between the timing of visits can be erratic, there has been hours between visits before”
moderateRecord keeping: “one person wore glasses to help them see, but their care plan stated that they had no visual problems. Another care plan documented that the person had no skin integrity issues, however, they required wound dressings”
moderateLeadership: “The service was not well managed... Leaders and the culture they created did not always support the delivery of high-quality, person-centred care”
Strengths
· People were protected from the risk of abuse with safeguarding and whistleblowing policies in place
· Safe recruitment practices including DBS checks, references and employment history checks
· Staff supplied with appropriate PPE and infection control training
· People received kind and compassionate care; staff treated them with dignity and respect
· Staff received equality and diversity training and Care Certificate induction
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and managementNot rated
safe: Using medicines safelyNot rated
safe: Staffing and recruitmentNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Learning lessons when things go wrongNot rated
safe: Preventing and controlling infectionNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to live healthier lives, access healthcare services and supportNot 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: End of life care and supportNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
well-led: Continuous learning and improving careNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Duty of candour and managers' understanding of roles, risks and regulatory requirementsNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Working in partnership with othersNot rated