Bramhams Homecare Ltd

Bramhams Homecare Ltd. is a domiciliary care agency which provides personal care to people living in their own houses and flats in the community. The agency currently caters for people whose main needs are those associated with older people, including people living with dementia. At the time of our inspection 16 people were receiving personal care from the service.

The service had 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 and associated Regulations about how the service is run.

People we spoke with were happy with the quality of the care the service provided and how it was run. They told us the care workers were very good and met their needs and delivered their care as they wanted it delivering.

Staff had been trained in safeguarding of vulnerable people from abuse and avoidable harm. Staff were knowledgeable about the potential risks and signs of abuse. Risks to people's safety and wellbeing were assessed and managed in the least restrictive way possible. There were sufficient suitably trained staff available to meet people's needs. People's medicines were safely managed. Staff had received training in infection control practices and personal protective equipment such as gloves and aprons was provided for them.

The management and staff team used incidents as a learning tool to help further ensure people's safety and wellbeing. Staff received training and supervision to enable them to meet people's care and support needs. The service worked within the principles of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People had consented to their planned care and staff understood the importance of gaining people’s consent and acting in their best interest. People were supported to eat and drink sufficient amounts to maintain their health and wellbeing. The staff and management team worked in partnership with external agencies to ensure people’s needs were identified and met.

People had a small team of staff who supported them which helped to ensure continuity and enabled people to form bonds with the staff. Staff understood the importance of promoting people's independence and respecting their dignity. People's care records were stored securely to help maintain their dignity and confidentiality.

People and their relatives had been involved in developing care plans that addressed all areas of people's lives. Staff were matched as far as possible with the people they supported in terms of gender, interests and skills. People were enabled to raise complaints and concerns. The people we spoke with told us they would feel comfortable raising concerns, if they had any. When concerns had been raised the correct procedure had been used to record, investigate and resolve issues.

There was a range of routine checks undertaken by the management team which were effective in identifying shortfalls. The management team were passionate about providing good care and support and demonstrated an in-depth knowledge of the staff they employed and people who used the service.

People had been given opportunities to share their opinions about their service provision and action had been taken to address areas for improvement.

Further information is in the detailed findings below.

This was the first inspection of the service since it was registered in January 2014.

Bramhams Homecare Limited is a small domiciliary care agency which provides care services to people in their own homes. On the day of our visit 18 people were receiving a personal care service. The agency can provide a service to adults, older people, people living with dementia, people with physical disabilities, people with mental health conditions and people with sensory loss.

There was a registered manager in post, who is also the owner of the company. 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 who used the service told us they felt safe with the care they received. We found there were appropriate systems in place to protect people from risk of harm.

There were policies and procedures in place in relation to the Mental Capacity Act 2005 and Deprivations of Liberty Safeguards (DoLS).

We found that people were provided with care and support by staff who had the appropriate knowledge and training to effectively meet their needs. The skill mix and staffing arrangements were also sufficient. Robust recruitment processes were in place and followed, with appropriate checks undertaken prior to staff working at the service. This included obtaining references from the person’s previous employer as well as checks to show staff were safe to work with vulnerable adults.

Staff had opportunities for on-going development and the registered manager ensured they received induction, supervision, annual appraisals and training relevant to their role.

The staff we spoke with were able to describe how individual people preferred their care and support delivered and the importance of treating people with respect in their own homes.

People using the service and relatives told us staff were reliable, kind and caring and always provided care and support in line with the support plan in place. We found staff provided a person centred service.

The care plans we looked at were person centred and reviewed on a regular basis to make sure they provided accurate and up to date information. The staff we spoke with told us they used the support plans as working documents and they contained sufficient information to enable them to carry out their role effectively and in people's best interest.

Medicines management systems were in place to ensure people received their medicines at the right times. When necessary staff involved district nurses, GP’s or the emergency services to make sure people’s health care needs were met.

People’s individual dietary needs and preferences were being planned for and met.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received.

People using the service, relatives and staff we spoke with were very positive about the registered manager. They all said the registered manager was committed to providing the best service they could offer, was approachable and provided effective leadership. Relatives and staff all said they had and would recommend the service to other people.

There was a quality assurance monitoring system in place that was designed to continually monitor and identify any shortfalls in service provision.

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