Heart of Gold Homecare Ltd

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained the same. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The provider breached regulations in relation to safe care and safeguarding. The registered manager was completing competency assessments with staff members in relation to percutaneous endoscopic gastrostomy (PEG) care, medication management and moving and handling, despite them not having the qualifications or experience to do so. The registered manager had failed to identify 2 safeguarding concerns which were picked up by the CQC and the local authority and failed to escalate 1 of them.

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained the same. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has remained the same. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained the same. This meant people’s needs were met through good organisation and delivery.

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained the same. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The provider breached regulations in relation to governance. Although the provider had governance systems and processes in place, they were not robust. There was a lack of evidence of regular audits taking place and those which were shown were not robust and did not feed into the continuous improvement plans. Other systems and processes for reviewing policies and mandatory training needed to be operated more effectively to ensure compliance.The provider also needed to ensure there were robust review arrangements of people’s complex needs (e.g. PEG care) via ongoing clinical review in collaboration with external healthcare professionals. Review arrangements including frequency, roles and responsibilities needed clearly identifying.