We inspected Betamindes on 5, 6 and 7 October 2016. As this was a domiciliary care agency service, we contacted the registered manager 48 hours’ before the inspection. This was so that we could ensure that staff were available at the office. At the last inspection in October 2013 we found the service met all the regulations we looked at.Betamindes is a domiciliary care agency which is registered to provide personal care to adults who live in their own homes. The registered manager is also the owner and director of the company, along with another owner/director. At the time of the inspection, there were 50 adults in receipt of personal care.
There was a registered manager in place. 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 people were very positive and complimentary about the service they received. People using the service told us they felt safe and the relatives we spoke with also agreed people were safe. We found that people were protected from the risk of harm and abuse. All staff spoken with had a good understanding of safeguarding, the signs of abuse, and how to report it. Although two staff were unsure where they could report concerns to outside of their organisation. We found that the service had a safeguarding policy in place we saw that the registered manager had reported safeguarding concerns appropriately as per local procedures.
There were sufficient staff to meet the needs of people receiving a service. The service was recruiting new staff. People told us that staff always arrived on time and calls were not missed
People’s medicines were administered safely. However we found that staff’s competency to administer medication was not always recorded robustly. The service had implemented a new staff coordinator role and her focus was on the development of training and induction. Staff told us that they had undergone an induction and shadowed experience staff when they started work at the service. Staff also undertook refresher training in subjects that the service identified as mandatory as well as in others topics such as health conditions.
We found that staff had some awareness of the Mental Capacity Act 2005 (MCA). Staff sought consent from people prior to undertaking any care. The service took people’s mental capacity in account when making decisions about their care and treatment. However we found that the records which demonstrated that mental capacity assessments and best interest decisions had been carried out were not always robust enough.
Staff were kind, caring and compassionate. People told us that staff treated them with dignity and respect. We found that staff had developed effective caring relationships with people.
Care plans were in place. They provided sufficient details and were regularly reviewed and updated. The care plans and risk assessments provided sufficient information to enable staff to meet their care needs. Some were detailed and included people’s preferences and choices, whilst others would benefit form more person canted information. We found that people were supported to maintain as much independence as possible. People told us that the service was very flexible and accommodated any changes to people’s needs.
People had access to the complaints procedure and told us that they knew how to make a complaint should they need to. We found that the management team had regular contact with people and dealt with any issues and concerns as they arose.
People using the service and staff told us that the service was well led. People found that the registered manager and management team were very approachable and responsive. The registered manager had already identified areas for improvement within the service. Changes to the management structure and the development of new roles was underway. There were some quality assurance systems in place and we spoke with the registered manager about developing these further. There were systems in place to monitor the care provided and people's views and opinions were sought regularly about the quality of the service.