Bluewood Care Limited

Bluewood Care Ltd is a domiciliary care agency registered to provide personal care to people in their own homes. The service provides support to older people and younger people with a range of needs. This includes people with physical disabilities. At the time of our inspection the service supported 6 people, some of those people, received 24-hour care and support.

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

The quality and safety of the service had deteriorated since our last inspection. Medicines were not managed safely in line with the provider’s policy and best practice guidance. Risks associated with people’s care were not always identified, assessed, or well managed.

Quality assurance systems and processes were ineffective, as they failed to identify the issues we had found, such as there was no guidance for staff to follow when administering emergency medicines to people. Opportunities to learn lessons had been missed.

Care records did not include an assessment of people’s needs and choices to ensure staff knew how people wished to be supported. Improvements were needed in the quality of training staff had received to ensure staff supported people safely.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. We made a recommendation to the provider regarding improvements to be made to ensure they were working within the principles of the Mental Capacity Act 2005.

Staff understood their responsibilities to keep people safe and protect from harm. Staff were recruited safely and there were sufficient staff to provide people’s care and support.

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 this service was good (published 16 August 2018).

Why we inspected

This inspection was prompted due to concerns received in relation to the quality of care and the safety of people using the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective 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 comprehensive inspection, by selecting the ‘all reports’ link for Bluewood Care Ltd on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to people’s safety and the governance of the service at this inspection.

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 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.

Bluewood Care Ltd is a domiciliary care agency registered to provide personal care to people in their own homes. At the time of this inspection the service supported four people with personal care and employed four care staff.

This was the first inspection of the service following their registration with us in November 2017.

A requirement of the provider’s registration is that they have a registered manager. There was a registered manager in post at the time of our inspection. 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 felt safe using the service and there were enough staff to provide the care and support people required. People received care from staff they knew and who arrived around the time expected. Staff had completed safeguarding training and understood how to keep people safe from avoidable harm and abuse.

Risks to people’s safety were identified and assessments completed to provide guidance for staff about how to reduce or manage the risk. The provider’s recruitment procedures made sure staff were safe to work with people who used the service. People received their prescribed medicines from staff who had completed training to do this safely.

People had an assessment completed at the start of their service to make sure staff could meet their care and support needs. Staff received an induction when they started working for the service and completed training that provided them with the skills and knowledge to support people’s needs. When needed, arrangements were in place to support people to have enough to eat and drink and remain in good health.

People's right to make their own decisions about their care were supported by the registered manager and staff who understood the principles of the Mental Capacity Act. Staff asked for people’s consent before they provided care and respected decisions people made about their care and support.

People received care from staff who they considered to be kind and caring, and who stayed long enough to provide the care and support people required. Staff knew people well as they visited the same people regularly. Staff promoted people’s privacy and dignity and people received care and support which was individual to them.

Care plans provided information for staff about people’s individual preferences and care needs. Plans were regularly reviewed and people said the service was flexible and responsive to their needs. People knew how to complain, and information about making a complaint was available for people.

The registered manager and provider used feedback from people to assist them in making improvements to the service. Staff understood their roles and responsibilities and said they had regular individual meetings and observations of their practice to make sure they carried these out safely. There were some processes for assessing and monitoring the quality of the service but record keeping and overall governance required improvement. The provider acknowledged they would need to continually review and develop their current systems if the size of the agency was to increase.