About the service:

• The service’s office is based in the Slough trading estate. Care is provided in the surrounding areas and into greater London areas.

• The service provides personal care to older adults, some of whom have dementia.

• This is the only location that the provider operates.

• At the time of our inspection, six people used the service and there were 11 staff.

People’s experience of using this service:

• The provider had made some improvements to the service since our last inspection. This meant the service had achieved compliance with the prior breaches of regulations.

• The governance of the service had not improved and therefore there is a breach of a regulation.

• The service had improved the amount of staff support. This included induction processes, supervision sessions, training and retraining and performance appraisals. Further improvements were needed to ensure that staff supervisions and appraisals were meaningful.

• Recruitment documentation had improved. The provider had ensured that more robust checks of new workers were completed, and obtained the appropriate documentation for personnel files.

• People were better protected against abuse and neglect. Systems and processes put into place where strengthened to ensure adults at risk were identified and safeguarded.

• People and relatives reported the service remained caring. Care was person-centred and planned and reviewed in conjunction with people and others.

• Insufficient processes are in place for the assessment of the safety and quality of care. More management oversight was required to ensure good governance of the service.

• The service’s ratings for each key question have not changed since our last inspection. The overall rating for the service remained at “requires improvement”.

• More information is in our full report.

Rating at last inspection:

• At our last inspection, the service was rated “requires improvement”. Our last report was published on 22 December 2017.

Why we inspected:

• All services rated “requires improvement” are re-inspected within one year of our prior inspection.

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

• The service is required to provide an action plan to us because there is a breach of a regulation.

• We made recommendations in our inspection report, which we will follow up at our next inspection.

• We will inspect the service again within one year of the publication date of this report.

Our inspection took place on 13 November 2017 and was announced.

Goldcrest Care Services Ltd is a small domiciliary care service based in Slough, which provides personal care to people in their own home. At the time of our inspection, four people used the service.

People were not always protected from abuse and neglect. Appropriate systems were not in place to safeguard people from the risk of preventable harm. Recruitment practices and supporting documentation did not meet the requirements set by the applicable legislation. We found appropriate numbers of staff were deployed to meet people’s needs. People’s medicines were safely managed.

The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People were assisted to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Staff induction, training, supervision and performance appraisals were lacking or insufficient and the service could not ensure workers had the necessary knowledge and skills to effectively support people. People’s care preferences, likes and dislikes were assessed, recorded and respected. We found there was collaborative working with other community healthcare professionals.

The service was caring. There was complimentary feedback from people who used the service. People told us they were able to participate in care planning and reviews and some decisions were made by staff in people’s best interests. People’s privacy and dignity was respected when care was provided to them.

Care plans were appropriate and contained information of how to support people in the right way. We saw there was an appropriate complaints system in place which included the ability for people to contact any office-based staff member or the management team. People and relatives told us they had no current concerns or complaints. Questionnaires were used to determine people’s satisfaction with the care.

Provider-level methods of good governance such as audits were not implemented at the service and therefore the quality and safety of the service could not be adequately measured. We made a recommendation about this. People told us that the management were friendly and approachable. They felt that the service was well-led.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and an offence under the Health and Social Care Act 2008.

You can see what action we told the provider to take at the back of the full version of our report.

Full information about our regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals are concluded.