Boldglen Limited Medway Swale

Updated 28 April 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 2 inspectors, 1 of whom carried out telephone calls with staff. The inspection also was supported by 2 Experts by Experience, who carried out telephone calls with people and relatives. 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. This service also provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

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 we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 21 March 2023 and ended on 4 April 2023. We visited the location’s office on 21 and 22 March 2023. We carried out staff telephone calls between 28 March and 4 April 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who commission the service. We also sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. Healthwatch told us they had not visited the service or received any comments or concerns.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people and 9 relatives about their experience of the care provided. We spoke with 7 members of staff including the registered manager, coordinators and care staff.

We reviewed a range of records. This included 9 people's care records and medicines records. We looked at 4 staff files in relation to recruitment, staff supervision and training. A variety of records relating to the management of the service, including checks and audits were reviewed.

Updated 28 April 2023

About the service

Boldglen Limited Medway and Swale is a domiciliary care service providing personal care to people living in their own homes. The service also provided personal care to people living in flats within an extra care housing scheme in the borough of Swale. 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. The service was providing personal care to 65 people at the time of the inspection.

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

People and relatives had positive views about the service. Comments included, “The care I get is very good and really appreciate it”; “My carer really understands how I like things done and she always makes sure that is what I get”; “I think that they do a good job. The most important thing is that she is comfortable and happy with them” and “I would highly recommend them.”

We could not be assured new staff were adequately checked to ensure they were suitable to work with people to keep them safe. We found no evidence that people had been harmed however, systems were not robust enough to demonstrate staff recruitment was effectively managed.

There was a quality and assurance system in place and the provider had carried out the appropriate checks to ensure that the quality of the service was maintained. The provider had identified issues relating to people’s care and taken action to address these. However, the provider’s quality monitoring processes had not identified issues with safe recruitment practice, this is an area for improvement.

Risk assessments were in place to provide guidance to staff on how to support people. These were detailed and clear. However, safe ways of working when pets were present in a person’s home were not always listed. We discussed this with the registered manager as an area for improvement. Care plans contained up to date information about people’s medicines, as well as their care and support needs.

Prior to people receiving a service their needs were thoroughly assessed. People’s oral care, medicines and health needs were included in the information obtained before care packages started to enable staff to provide safe, person-centred care and support.

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) and wore this to keep themselves and people safe.

Enough staff were deployed to keep people safe. People were supported by regular staff who they knew well. Staff were well supported by the management team. Staff had completed mandatory training.

Care plans were in place which provided a list of tasks for staff to complete. These were person centred and detailed to show new staff what all the tasks were. People and their relatives told us staff knew their needs and preferences well. They told us they had been involved with the care planning process.

People and relatives knew how to complain. 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 and update

The last rating for this service was requires improvement (published 23 October 2019). We served the provider conditions on their registration after the last inspection.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At the last inspection, we recommended that the provider reviews how to effectively deploy staff to enable them to carry out their duties to meet people's care and support needs and update their travel time practice accordingly. At this inspection we found the provider had acted on the recommendation.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations 9, 11, 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider remained in breach of regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safe recruitment practice. This service has been rated requires improvement for the last three consecutive rated inspections.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Enforcement

We have identified a breach in relation to safe recruitment practice at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.