Be Caring Leeds

Updated 25 December 2021

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 Care Act 2014.

Inspection team

The inspection team was made up of two inspectors, a pharmacist and three experts 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

Be Caring Leeds is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager however, they had not yet registered with the Care Quality Commission to become the registered manager. Therefore, the provider was legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice. This was because we needed to be sure that the provider or manager would be in the office to support the inspection. Inspection activity started on 3 September 2021 and ended 14 October 2021. We visited the office on 7 September 2021.

What we did before the inspection

We reviewed information we had received about the service. The provider was not asked to complete a provider information return prior to this inspection. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report.

We sought feedback from the local authority, clinical commissioning group and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used this information to plan our inspection.

During the inspection

We spoke with 14 people and 18 relatives about their experience of the care provided. We spoke with the nominated individual, the manager and staff members. We looked at care and medicine records, staff files for recruitment and risk assessments. We also looked at quality monitoring records relating to the management of the service, such as audits and quality assurance reports.

After the inspection

We continued to seek clarification from the provider to validate evidence found. This included reviewing feedback about the service and quality assurance records.

Updated 25 December 2021

Be Caring Leeds is a domiciliary care service which provides personal care to adults with a range of support needs in their own homes. At the time of this inspection the service was supporting 242 people.

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.

People’s experience of using this service and what we found

At the last inspection we found the provider was in breach of regulation 12 and 17 as governance systems were not robust and medicines were not managed safely. We also made a recommendation for the provider to improve their staffing. At this inspection we found the service had not made enough improvement and remained in breach of these regulations.

The provider failed to assess, monitor and improve the quality of the service and maintain accurate and robust care records. We found shortfalls in recordings; for example, medication administration records (MARs), care plans and risk assessments were not always signed, updated or completed.

Medicines were not always managed safely. People we spoke with were not confident their medicines were administered at the correct times due to visits being late. Medication administration records (MARs) were not always accurately written or signed for by staff following administrations.

We found evidence staffing levels were not adequate as rota’s showed staff did not always stay the allocated times. People we spoke with and their relatives said staffing levels were not sufficient as visits were often late or missed due to staff shortages.

Some care plans lacked up to date and accurate information to guide staff. Risks to people and how they were managed were not always fully reflected in risk assessment documentation. Staff knew people’s needs and how to care for them however, some people we spoke with said staff required further training to meet their needs.

People told us they felt safe with staff visiting their homes. There were systems in place to recognise and respond to any allegations of abuse.

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. Basic information was recorded for people’s capacity status however, decision specific capacity assessments and best interest decisions had not been recorded.

People told us staff were kind, caring and supportive. People's privacy was valued by staff who maintained people’s dignity. Staff ensured they always offered choice and encouraged people to remain independent when their health allowed.

Complaints we looked at were managed with actions taken to address the concerns and most people felt their concerns would be responded to.

Staff were aware of infection control practices in relation to the latest COVID-19 government guidance for the use of personal protective equipment (PPE) to keep people and staff safe.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service under the previous provider was rated good (published 4 July 2019). CQC carried out a responsive inspection of Be Caring Leeds looking at the safe and well led key questions and found two breaches of regulation 12 and 17 (published 21 April 2021). The overall rating published on 21 April 2021 was requires improvement.

Why we inspected

The inspection was prompted in part due to concerns received about safe care and treatment. We had been contacted by the local safeguarding team about ongoing concerns within the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvement. Please see the safe, effective, caring, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last focused inspection, by selecting the ‘all reports’ link for Be Caring Leeds on our website at www.cqc.org.uk.

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified three breaches in relation to safe care and treatment, staffing and governance.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.