Bespoke Health & Social Care

Updated 3 September 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed 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.

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 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 14 July 2019 and ended on 20 July 2019. We visited the office location on 14 July 2019 and made telephone calls to people who used the service and staff after this visit.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report and gave them the opportunity throughout the inspection visit to update us.

During the inspection

We spoke with the registered manager, the clinical lead and the human resources manager. We spoke with nine care staff after the inspection, as the staff work across the country and were not able to attend the head office. We reviewed a range of records. These included five people’s care records and associated information. We reviewed a variety of records relating to the management of the service, including complaints and staff training /competency checks. We also reviewed the recruitment records for three staff members.

After the inspection

We sought additional assurances around the management of the service and plans to embed some policies and procedures. We also spoke with five people who used the service and three relatives by telephone.

Updated 3 September 2019

About the service

Bespoke Health & Social Care is a domiciliary care provider providing personal care to 134 people at the time of the inspection. It provides personal care for people living in their own homes, so they can live as independently as possible.

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

People were supported by staff who had the knowledge and skills to ensure they were safe from harm. Risk assessments had been completed to consider what support was needed in these areas to reduce the risks. Staff were recruited in line with best practice and the number of staff were reflective of the package needs. Medicines were managed safely, and staff ensured clear infection control practices. The provider had reflected on incidents and lessons had been learnt.

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 in the service supported this practice. Staff had received training relevant to their role and this was in line with best practice and current guidelines. When people required support with their nutritional needs this was documented and reflective of the individual. Health care was promoted, and the staff worked in partnership with many health and social care professionals.

The care was provided by staff, which people told us were kind and compassionate. People’s needs were respected, and care provided in a dignified way. Care plans reflected the individuals needs and they had been integral to the package of care. People’s communication needs were identified and supported along with any cultural or religious needs.

The provider ensured that any complaints had been responded to and people and staff were encouraged to feedback about the service. Any issues were reviewed and agreed outcomes of change made. There was a planned approach to reflecting the quality of the service, audits were used to ensure records and medicines were administered safely. There was a range of improvements which were being driven by the changing market and feedback on the service outcomes. The provider worked with a range of partners to support people’s health and social needs.

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 7 March 2017). The service was rated as requires improvements in ‘Safe’ and we saw improvements had been made in this area.

Why we inspected

This was a planned inspection based on the previous rating.