BIG Healthcare Limited.

Updated 27 April 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by one inspector.

Service and service type:

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to children, younger adults, older people and people living with dementia.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are 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 three days’ notice of the inspection site visit. This was to enable the registered manager to gain people’s consent for us to contact them for feedback about the service before we visited the office.

Inspection site visit activity started on 14 March 2019 and ended on 18 March 2019. We visited the office location on 18 March 2019 to see the manager and office staff; and to review care records and policies and procedures.

What we did:

Before the inspection we contacted the local authority quality assurance and safeguarding teams and Healthwatch Staffordshire for feedback about the service. Healthwatch is an independent national champion, making sure that those running health and social care services, and the government, put people at the heart of care. We used the feedback received to help create a plan for the inspection. The provider was unable to submit a Provider Information Return (PIR) before the inspection due to technical difficulties but submitted it shortly after the inspection. A PIR is information we ask providers to send us at least once a year to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with four people being supported by the service and three people’s relatives. We also spoke with three support workers, the field supervisor, the office manager and the registered manager. We reviewed the care records of two people receiving support. In addition, we looked at service records including staff recruitment, supervision and training records, policies and procedures, complaints and compliments records, audits of quality and safety, fire safety and environmental health records.

After the inspection, we contacted two people’s social workers for feedback about the support provided by the service. In addition, the registered manager provided evidence of the improvements made to medicines documentation.

Updated 27 April 2019

About the service: BIG House is a domiciliary care service, which provides personal care and support to children and adults. The service was supporting eight adults at the time of the inspection. No children were being supported. The registered manager told us the service had started providing people with support from 20 January 2019.

People’s experience of using this service:

People who used the service and their relatives told us they were very happy with the support provided by BIG House.

People felt safe when staff supported them and told us staff visited them when they should. The provider followed safe processes when recruiting staff and staff understood the action to take if they witnessed or suspected abuse. The service managed people’s risks appropriately and people received their medicines in a safe way. Some minor improvements were needed to medicines documentation and the provider actioned these shortly after the inspection. People were protected from the risks associated with poor infection control.

The service provided people with care and support which met their needs. People felt staff had the knowledge and skills to support them effectively. Staff received a thorough induction when they joined the service and completed the provider’s required training, which helped to ensure they were able to meet people’s needs. Mental capacity assessments had been completed in line with the Mental Capacity Act 2005 and people’s relatives were consulted when they were unable to make decisions about their care. Staff supported people appropriately with their nutrition, hydration and healthcare needs and the service referred people to community professionals when they needed additional support.

People liked the staff who supported them and told us staff treated them with kindness and respect. People’s diversity was respected and they received any support they needed with their communication needs. Staff respected people’s right to privacy and dignity and people’s personal information was kept confidential. People told us their care needs had been discussed with them and they were involved in decisions about their care. There was no information available about local advocacy services. The registered manager told us he would find out about local services and ensure this information was passed on to people supported by the service.

People receive personalised care which reflected their needs and preferences. Care plans and risk assessments were individualised and updated when people’s needs or risks changed. People were supported by a small number of staff who knew them and how they liked to be supported. Staff gave people choices and encouraged them to make every day decisions about their support. No complaints had been received by the service. However, we saw evidence that minor concerns were dealt with quickly and effectively.

People supported by the service and their relatives were happy with how the service was being managed. We found evidence that the service was providing people with person-centred, high quality care. Staff liked working at the service and told us they felt well supported by the registered manager. The service sought regular feedback from people about the care provided. People expressed a high level of satisfaction with the support they received. The registered manager and senior staff completed regular checks of staff competence and care documentation. The checks completed were effective in ensuring the service maintained appropriate levels of quality and safety.

The service met the characteristics of Good in all areas.

Rating at last inspection: This was our first inspection of the service.

Why we inspected: This was a planned inspection.

Follow up: We will inspect the service again in line with its rating. We will continue to monitor the service to ensure that people receive safe, effective care and may inspect the service sooner if we receive concerning information.

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