We carried out this inspection on 18 May 2018.

At our last comprehensive inspection in April 2017 we found breaches of regulations regarding staff recruitment and the management of medicines. We carried out a focussed inspection in September 2017 where we found the provider was now meeting regulations concerning the management of medicines but was still not meeting regulations about staff recruitment.

At this inspection we found the provider had made the necessary improvements and was now meeting regulations. We have changed their rating from “Requires Improvement” to “Good”.

Golden Key Support is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of our inspection there were 25 people using the service. These were primarily older people and people with physical disabilities. The provider had applied to provide support to children with disabilities, but had not started doing so at the time of this inspection.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People’s needs and preferences for their care and health needs were assessed before they started to use the service, and care plans were designed in order to meet these. Care plans were reviewed regularly to make sure they met people’s needs, and we saw care was delivered in line with these, although we saw a small number of cases where there were discrepancies between what care was planned and what care staff had recorded had taken place. People received support in line with their cultural needs and were supported to have varied diets.

The provider obtained suitable consent to care and had assessed people’s capacity to consent to care, but lacked procedures in the event they needed to document that they were providing care in people’s best interests.

Risks to people using the service were assessed and there were measures to keep people safe. People were safeguarded from abuse, and when there were concerns staff were aware of their responsibility to speak up and had confidence in the manager’s ability to address these. Processes were followed in order to investigate and address complaints and allegations.

The provider followed safer recruitment measures to make sure people were suitable for their roles. People told us that care workers were punctual and reliable, and that they felt treated with respect. People consistently received care from the same care workers, who could meet their cultural and language needs.

The provider had revised their policies regarding the management of medicines prior to their last inspection, and we saw that this improvement was sustained to ensure people received their medicines safely.

Staff told us they felt well supported by managers. Care workers received regular training and supervision to make sure that they had the right skills for their roles.

There were systems in place to make sure people were regularly consulted about their care, both by telephone and in routine home visits. These were used to make sure people were satisfied and whether any aspect of their care needed to change. There were consistently high levels of satisfaction with the service provided.

We carried out an announced inspection of this location on 28 April and 2 May 2017. Breaches of regulations were found in relation to staff recruitment and the management of medicines. We issued a warning notice requiring the provider to make improvements with regards to staff recruitment processes; after this inspection the provider wrote to us to say what they would do to meet legal requirements.

We undertook this announced focussed inspection on 14 September 2017 to check whether the provider had followed their action plan and made the necessary improvements to meet legal requirements. This report only covers our findings in relation to these areas. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Golden Key Support Ltd’ on our website at www.cqc.org.uk’

Golden Key Support is a domiciliary care agency which provides care and support to older people and people with physical disabilities in East London. At the time of our inspection there were 23 people using the service.

The location had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found that the provider had met the requirements of the warning notice regarding staff recruitment. We had issued this notice as we found that five staff were working for the agency who had fraudulent references from previous employers, and that the provider had failed to carry out a risk assessment for a staff member who had information of concern on their background check. At this inspection we found that the provider had obtained alternate references for these staff and made calls to confirm that references were genuine, and that they had carried out a suitable risk assessment for this staff member. They had introduced a system for verifying that background checks were in place before a staff member was signed off to start work. However, the provider was still not meeting this regulation, as although they had obtained references for staff, we found that some care workers’ references did not provide satisfactory evidence of previous employment in health and social care.

At our previous inspection we found that the provider was not meeting regulations regarding the safe management of medicines. We found that the provider was now meeting this regulation, as they had obtained suitable medicines administration charts for people they were supporting, and these were now fully audited by the registered manager to ensure that they were properly completed. Relatives of people who used the service were positive about the changes made by the provider.

We found one breach of regulations relating to staff recruitment and you can see what action we told the provider to take at the end of the full version of this report.

We carried out this announced inspection on 28 April and 2 May 2017. This was the first inspection since this service registered in July 2016.

Golden Key Support is a domiciliary care agency which provides care and support to older people and people with physical disabilities in their own homes. At the time of our inspection there were 20 people using the service across three East London boroughs, who accessed the service through direct payments. The majority of people had started using the service in the last four months.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The provider had measures in place for protecting people from abuse, and had carried out detailed risk assessments in order to mitigate risks to people who used the service. There was information on how to meet people’s health needs and ensure that people received the right support with nutrition. The provider had assessed people’s needs with regards to medicines, however medicines were not safely managed or audited in a way which could detect errors.

Pre-employment checks were carried out on staff, however, we found that safer recruitment processes were not always being followed, and some staff were working with fraudulent references from previous employers.

Care was planned and delivered in a way which met people’s needs, and people who used the service and their relatives praised the quality of the service. People told us that staff were punctual and reliable, and that the service could accommodate changes in times. People had consented appropriately to their care and the provider had assessed people’s capacity to make decisions about their care. People told us they were very happy with the care provided and would recommend the service to their friends.

People were involved in their care planning and benefitted from very consistent staffing. There were systems in place for responding to complaints appropriately.

Staff were well supported by managers and received appropriate shadowing, training and supervision in order to carry out their roles, including assessing staff training to meet the needs of individuals. There were systems in place to check that care was being delivered safely, including spot checks and regular telephone monitoring, and care records were audited to make sure that this was accurately recorded.

We found two breaches of regulation in relation to the safe management of medicines and failing to carry out appropriate pre-employment checks to ensure that staff were suitable for their roles. We issued a warning notice in relation to the provider's recruitment processes. You can see what action we told the provider to take at the back of the full version of this report.