Background to this inspection
Updated
17 February 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 24 hours' notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 29 November 2022 and ended on 15 December 2022. We visited the location's office on 30 November 2022.
What we did before the inspection
We reviewed information we had received about the service. We also looked at notifications about important events that had taken place in the service, which the provider is required to tell us by law. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We contacted health and social care professionals to obtain feedback about their experience of the service. These professionals included local authority commissioners. We used all of this information to plan our inspection.
During the inspection
We spoke with 5 people who used the service and 1 relative about their experience of the care provided. We spoke with 7 members of staff including the registered manager, a care co-ordinator, a senior carer, 3 care workers and a member of regional management.
We reviewed a range of records. This included 4 people's care records in detail and multiple medicines records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, electronic call logs and company policies and procedures were reviewed.
Updated
17 February 2023
About the service
Brunswick Village is a domiciliary care service which provides personal care to people living in their own homes. The office was located within a new extra care scheme development. 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.
No one living in Brunswick Village apartments received help with personal care. At the time of the inspection there were 14 people living in the wider community receiving care and support with personal care.
People's experience of using this service and what we found
Enough staff were deployed to meet people's assessed needs as the registered manager could draw on a pool of staff from the wider company. However, staff were not always deployed effectively as visit times were not always consistent. People reported timings of visits varied as carers could be either early or late for visits, and we identified occasions when staff were not using the electronic call logging system appropriately. We have made a recommendation in relation to the deployment of staff, to ensure people receive care at the right time.
Whilst the provider carried out quality checks in relation to service delivery these had not identified the issues we found regarding inconsistent care calls, incorrect log in procedures and errors in record-keeping. The service was not always well-led however, the registered manager was open and receptive to explore ways to improve the service. Staff considered they were well supported by management of the service and the provider.
Risks to people's safety had been identified. Risk assessments contained all the information staff needed to keep people safe. Prior to people receiving a service their needs were always assessed to ensure these could be met. Medicines were administered safely by trained staff.
The provider had an up to date infection prevention and control (IPC) policy. Staff had completed IPC training. Staff had access to enough personal protective equipment (PPE). Staff had completed mandatory training.
New staff received an induction and a period of shadowing more experienced staff before working alone. Observations and spot checks were carried out to ensure staff had the required skills and competency. Staff were extremely kind and respectful to people and were mindful of the need to maintain confidentiality in their role.
Staff had good relationships with other health professionals and liaised with stakeholders to ensure people received appropriate support. Health professionals we contacted were extremely complimentary about the responsiveness of the service and their approach to person-centred care.
People and their relatives told us staff knew their needs and preferences well. People and relatives knew how to complain. Some people and relatives who had raised informal concerns said changes had been made following their complaints.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 4 March 2021 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We will continue to monitor the service and will take further action if needed. We have identified a breach in relation to good governance at this inspection and we have made a recommendation in relation to staffing and recruitment. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.