Archived: The Care Bureau Ltd - Domiciliary Care - Stratford- on- Avon

The Care Bureau Ltd - Domiciliary Care - Stratford- on- Avon provides personal care for people living in their own homes. Fifty-seven people were receiving personal care at the time of our inspection visit. 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

Relatives felt their loved ones were safe with staff supporting them in their own homes. Staff had been trained to protect people from the risks of abuse and understood how to keep people safe. Infection control procedures were in place to protect people from the spread of infectious disease and COVID-19. There were enough staff to visit people within their agreed time periods for their support calls.

People and their relatives were involved in initial assessments which took place before packages of care commenced. Care plans were based on the individual’s needs. Care plans were regularly reviewed to ensure staff had up to date and relevant information about people’s care needs. Where people required support at the end of their lives, the provider worked with people, their families and health professionals to achieve good outcomes for people.

People received care from staff who were trained, motivated and supported by a registered manager who led the staff team to provide the best care they could. People using the service benefited from a well led service. Partnership working enabled people to maintain their wellbeing. Quality monitoring systems and processes were in place to provide information on how the service could be continuously improved.

Rating at last inspection: At the previous inspection in May 2019 the service was rated Requires Improvement in three areas, Safe, Responsive and Well Led. We found there were two breaches of the Regulations in Well Led. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of the Regulations. At this inspection we have rated the service as Good in all these three areas, giving the service an overall rating of Good.

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

Why we inspected

We inspected to follow up on our previous findings in our inspection of May 2019. This was a focussed inspection where we only looked at the three key areas of Safe, Responsive and Well Led.

Follow up

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

People’s experience of using this service:

People’s needs and wishes were assessed before they started to use the service.

These needs and wishes were recorded in people’s care plans.

Care plans were regularly reviewed to ensure staff had up to date and relevant information about people’s care needs.

Staff knew about the risks associated with people’s care and how to minimise these. However, these risks were not always reflected in people’s care plans for staff to refer too.

People told us when staff were there, they were caring, kind and knew them well.

Although staff never missed a call, people told us they were much earlier or later than they liked which had an impact on their emotional well-being.

Staff were recruited safely, and processes checked the background of potential new staff.

Staff understood how to keep people safe and how to report any concerns they may have.

Action was taken to safeguard people from abuse. However, statutory notifications for specific incidents were not always sent to us.

Staff supported people to take their medicines as prescribed.

Staff understood how to prevent the spread of infection.

Staff received the training and guidance they needed to complete their role well.

People made their own decisions about their care and were supported by staff who understood the principles of the Mental Capacity Act 2005.

People were offered choices. For example, in the meals and drinks they were offered.

Staff respected people’s rights to privacy and dignity.

People received information about the service in a way that was appropriate to their needs

People did not always feel confident to complain

Systems and processes had not always been effective in ensuring the quality of the service delivered

Rating at last inspection: Good. (The last report was published on 8 November 2016).

Why we inspected: This was a planned inspection to confirm that the service remained Good. The service is now rated ‘Requires Improvement’.

The registered provider was in breach of regulation 17 of the HSCA (Regulated Activities) Regulations 2014: Governance and Regulation 18 of the Care Quality Commission (Registration) Regulations 2009: Notification of other incidents.

Enforcement: Action we told provider to take (refer to end of full report).

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

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

There was a registered manager in post. 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 told us they felt safe with the staff because they trusted them. Staff were trained in safeguarding and understood the signs of abuse, they were confident any concerns raised would be handled appropriately by the registered manager. The provider’s policies for keeping people safe included pre-employment checks, to make sure staff were suitable to deliver care in people’s own homes.

Risks to people’s health and wellbeing were identified at the initial assessment of care and their care plans included the actions staff should take to minimise the risks. Staff understood people’s needs and abilities because they read their care plans and shadowed experienced staff. Staff regularly worked with the same people so they knew them well.

The manager assessed risks in each person’s home and guidance for staff minimised risks to people and to staff. Staff were trained in medicines management, to ensure they knew how to support people to take their medicines and to understand the importance of keeping accurate records.

Staff received the training and support they needed to meet people’s needs effectively. Staff had regular opportunities to reflect on their practice, to attend training in subjects that interested them and to consider their personal development.

The manager understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People made their own decisions about their care and support. Staff understood they could only deliver care and support if people consented to being supported.

People were supported to eat and drink sufficient for their needs. Staff referred people to healthcare professionals for advice and support when their health needs changed.

People told us staff were kind, caring and friendly. People said staff respected their privacy and independence. Care staff were thoughtful and recognised and respected people’s cultural values and preferences.

People were confident any complaints would be listened to and action taken to resolve them. When people raised issues, they were responded to immediately by the staff, supervisors and registered manager.

The provider’s quality monitoring system included asking people for their views about the quality of the service through telephone conversations, visits by a supervisor and regular questionnaires.

The registered manager checked people received the care they needed by monitoring the time staff arrived for scheduled calls, reviewing care plans and daily records, and through feedback from people and from supervisors.