Archived: Bramley Home Care Sherborne

Updated 7 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 7 and 8 November 2018 and was announced. The provider was given 48 hours' notice. This was so that we could be sure the office manager was available when we visited and that consent could be sought from people to receive home visits from the inspector.

The inspection was carried out by one inspector. We visited the office location on the first and

second day to see the interim manager and office manager and to review care records and policies and procedures. On the first day the inspector also carried out general observations and checked care records during five visits to people in their homes. The people we visited had given their permission for this to happen.

Before the inspection we reviewed all the information we held about the service. This included notifications the service had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we visited five people in their own homes and discussed the delivery of care. We also spoke with three relatives. We met with the interim manager, office manager and the care coordinator. We spoke with eight members of staff (one of these via email). Following the site visit we had telephone conversations with four people and two health professionals.

We reviewed five people's care files, policies, risk assessments, complaints, quality audits and the 2018 quality survey results. We looked at five staff files, the recruitment process, staff meeting notes, office emails to care staff, training, supervision and appraisal records.

We asked the interim manager to send us additional information after the visit including premises risk assessments, accidents and incidents logs and staff survey results. We received this by the date we had requested.

Updated 7 December 2018

The inspection took place on 7 and 8 November 2018 and was announced. This was our first inspection of this service. It was registered on 11 December 2017.

Bramley Home Care Sherborne provides domiciliary support services to people in their own homes. It provides a service to older people and younger adults some of whom have a physical disability, sensory impairment or dementia. At the time of our inspection there were 20 people receiving personal care from the service.

Not everyone using Bramley Homecare Sherborne received a regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service did not have a registered manager in post. A registered manager is a person who has registered with the CQC 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. The manager of Bramley Home Care Shaftesbury told us they had recently had their registered manager’s interview with the CQC and were awaiting the outcome to see if they had met the requirements to become the registered manager of Bramley Homecare Sherborne. In the interim the service was overseen by a full-time office manager.

People were supported by staff who had received safeguarding training and understood how to keep people safe from harm or abuse. Risks to people were assessed and managed. The service had a recruitment and selection process that helped reduce the risk of unsuitable staff supporting people.

People received their medicines on time and as prescribed by staff that had received the appropriate training and competency checks. Staff understood the importance of infection prevention and control and wore protective equipment appropriately when supporting people. Learning from accidents, incidents and near misses was analysed and shared with the team to reduce the chance of them happening again.

People’s needs were assessed with their involvement and, where appropriate, those important to them. People were consulted with about changes to their care plans and reviews. People were supported by staff who had an induction and an ongoing programme of training. Training covered mandatory topics and areas specific to people’s needs such as multiple sclerosis and diabetes. Staff received regular supervision and checks of their competency. People were encouraged and supported to eat and drink sufficiently.

The service understood the important of keeping people healthy by timely contact with health and social care professionals. Where people’s health needs changed staff supported and encouraged people to contact health professionals such as GPs and community nurses. Staff supported people in line with the principles of the Mental Capacity Act 2005 (MCA 2005). Where complex decisions were required mental capacity assessments took place and best interest decision meetings were held with involvement from relevant people.

Staff consistently demonstrated a kind and caring approach towards people. People’s privacy and dignity was supported at all times. People were supported by staff who were respectful and knew them well. People could make decisions and express their views about the care and support they received. People’s privacy and dignity was respected. One person told us, “They are all very discreet.”

People were supported in line with their assessed care needs. Care reviews were carried out by the office manager every three months and included a discussion with the person about their current or emerging needs. People were encouraged and, where required, supported to maintain friendships, contact with family and links with the community. Complaints were logged, progress tracked and resolved in line with the service’s policy.

People’s communication needs were assessed and detailed in their care plans. The service was not currently providing support to any people with end of life care needs but had been involved in discussions with people about their future end of life wishes when they had expressed a wish to do so.

There was an open and supportive culture at the service. Staff were encouraged to contribute their views and ideas. People were supported by staff who got on well with each other and enjoyed working for the service. One staff member said, “I’m really happy working here.”

Staff told us they felt supported and listened to. Communication between care staff and the management was good. The management kept people, relatives and staff up to date with developments in the service including via a newly created newsletter. People and staff had the opportunity to feedback through six monthly surveys. Regular staff spot checks were carried out with feedback given both individually and as a team. The service was aware of its role alongside partner agencies, such as GP surgeries and community nursing teams, in helping meet people’s fluctuating and wide-ranging health and social care needs.