Blue Arch Homecare

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 and what we found.

The person we spoke with and most relatives we spoke with were satisfied with the care that staff provided and with the management of the service, though two relatives were dissatisfied with some aspects of the service. This included some late calls and not having agreed call times. When we raised the issues of dissatisfaction with the registered manager, the issues were acted on swiftly.

Everyone we spoke with except two relatives, said safe care was provided. If they had any concerns, the registered manager would act on the issues raised and put measures in place to ensure safe care.

People were protected against abuse, neglect and discrimination. People had been largely protected against the risk of infection though the registered manager had to take action to ensure all staff wore full protective equipment.

Details of how to reduce risks to people's safety were included in people's care plans though one risk assessment lacked detail on encouraging a person to eat. Care plans reflected people’s individual needs.

Safe recruitment practices were largely in place to ensure only suitable staff worked at the service, though staff references had not always come from relevant past care employers. Enough staff were employed to meet people's needs. Timely calls were mainly in place to provide personal care. Quality assurance systems were in place to try to ensure people were provided with a quality service though call times and care provided was not always checked.

The registered manager understood their responsibilities and worked in an open and transparent way.

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

Why we inspected

The inspection was prompted by concerns we received that safe care was not being provided to some people. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained requires improvement based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect. We will continue to monitor the service and will take further action if needed.

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. At the time of the inspection 38 people were receiving personal care.

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

Since our last inspection improvement had taken place to infection prevention controls (IPC), these now needed to be embedded into day to day practice. Appropriate Personal Protective Equipment (PPE) was made available and worn by staff.

Improvement had taken place to staff recruitment procedures, these now need to be embedded into day to day practice. There was enough staff to meet people’s needs, people told us the staff who provided their care were consistent and knew them well.

The provider had implemented an electronic monitoring system to help with monitoring all aspects of the service. However, quality assurance checks were still not consistently being carried out in a timely manner, in order to ensure the care being delivered was safe and to a good standard.

Where the provider was responsible, people received their medicines safely and as prescribed by staff who had been trained and assessed as competent to administer medicines. The provider needs to complete regular medicine audits to check people consistently receive their medicines safely.

People told us they felt safe and confident with the care and support they received from staff. People were safeguarded from abuse and neglect by a staff team who were trained in safeguarding procedures.

Staff received relevant training to ensure that they had the required skills and experience to support people appropriately. Due to the COVID-19 face to face training had been postponed until January 2021, in the interim staff were completing on-line training.

Risk assessments had been completed to ensure people were supported to remain safe. There was clear guidance for staff on how to manage people’s risks.

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 supported this practice.

The provider and staff team were kind, caring and compassionate. People and their representatives told us that staff were kind to them and respected their dignity and their privacy.

Care records contained sufficient information about people’s needs and routines. End of life care planning was provided, however at the time of the inspection the provider confirmed no people were on end of life care pathways.

The provider had implemented a quality assurance system to give people opportunities to feedback on the service they received. The provider had systems in place to encourage and respond to any complaints or compliments. People told us they were comfortable approaching the provider if they had a complaint.

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

Rating at the last inspection (and update)

This service was registered with us on 4 April 2019. A focused inspection took place in July 2020 (Report published on 20 August 2020) the service was not rated and had multiple breaches in the regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

This was a full comprehensive inspection to check the provider had followed their action plan and to confirm they now met the legal requirements. Enough improvement had been made at this inspection and the provider was no longer in breach of the regulations.

We have made a recommendation regarding good governance.

You can read the report from our last focused inspection, by selecting the ‘all reports’ link for Blue Arch Homecare on our website at www.cqc.org.uk.

Follow up

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

Blue Arch Homecare Limited is a domiciliary care service providing personal care to people living in their own homes. At the time of our inspection sixty people were receiving personal care.

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

The provider did not have robust systems in place to ensure people were protected from avoidable harm. Risks to people's health and safety were not always assessed and managed. Investigations into incidents and accidents were not always analysed to learn lessons and prevent future occurrences.

Staff were not always recruited safely or in line with current legislation.

Staff training was not in line with mandatory training for care staff. Not all staff had completed a comprehensive induction and probation periods were not in place.

Staff felt supported by the provider, however formal supervisions and staff appraisals we’re not consistently taking place to ensure staff were supported.

Improvements were required with regards to infection control, as the feedback from people was poor in relation to the prevention and control of infection.

Improvements were required in relation to medicines management to ensure this was safe and people received their prescribed medication.

The provider did not have effective systems in place to monitor the quality of the service they provided or to drive improvements where needed. The lack of managerial oversight had impacted on people, staff and the quality of care provided. Improvements were not always made when things went wrong.

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; however, the policies and systems in the service did not support this practice.

Some feedback confirmed people were happy with the care and service they received from Blue Arch Homecare Limited. Other feedback confirmed there were concerns about the infection control practices and communication, when regular carers changed.

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

Rating at last inspection

This service was registered with us on 04/04/2019 and has not been inspected. .

Why we inspected

We received concerns in relation to a safeguarding incident. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We have found evidence that the provider needs to make improvements. We have not rated this inspection, as a comprehensive inspection is required of the service, covering all the domains, before a rating can be given. Please see the safe 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.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to the safe care and treatment of people, in particular regarding various gaps and inconsistencies in the risk assessment documentation and the safe administration of medicines. We found a breach of regulation regarding effective governance arrangements. We also found a breach of regulation regarding the employment of fit and proper persons.

Please see the action we have told the provider to take at the end of this report.

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.