Archived: Bradgate Homecare Limited

Updated 24 February 2016

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.

This inspection took place on 19 and 20 November and we returned on 2 December 2015. All days were announced. 48 hours’ notice of the inspection was given because the service is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.’

The inspection was carried out by an inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert had experience of caring for someone who used this type of service.

Before our inspection, we reviewed the Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed information we held about the service and information we had received about the service from people who contacted us. We contacted the compliance team from Leicestershire County Council to obtain their views about the care provided. The compliance team work with a provider to ensure that they are meeting their contractual obligations with the Council.

We reviewed a range of records about people’s care and how the service was managed. This included eight people’s plans of care and associated documents including risk assessments. We looked at four staff files including their recruitment and training records. We also looked at documentation about the service that was given to staff and people using the service and policies and procedures that the provider had in place. We spoke with the registered manager and four care workers.

We telephoned 20 people who used the service. We spoke with 14 people who used the service and two relatives of people who used the service. This was to gather their views of the service being provided.

Updated 24 February 2016

The inspection took place on 19 and 20 November. We returned on 2 December 2015. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that the registered manager would be available to speak with. At the last inspection in September 2014 we found the provider had not met the regulation relating to management of medicines. At this inspection we found the provider had not made the required improvements. We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

The service provided care and support to adults with a variety of needs living in their own homes. This included people living with dementia, older people, people with sensory impairments and physical disabilities. At the time of inspection there were 124 people using the service.

The service had a registered manager. 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 told us that they did not always feel safe when staff supported them. They told us that this depended upon which staff member was supporting them.

People did not receive their medicines safely. Records did not contain important information about the medicines that people were taking and care plans did not show what support people needed with their medicines this meant that there was a risk that people might not receive the medicines they needed as prescribed by their doctor and there had been occasions when this had happened.

Risk assessments were in place which set out how to support people in a safe manner in areas such as moving and handling, nutrition and health and safety. The service had safeguarding and whistleblowing procedures in place. Staff were aware of their responsibilities in these areas.

Staff told us that they sought people’s consent prior to providing their care. We saw that there were a number of consent forms in place that the service used. Where people were believed to not have the capacity to consent to their care and treatment there was no record of how the care provided had been agreed as required by the Mental Capacity Act 2005.

Care workers were supported through training to be able to meet the care needs of people they supported. They undertook an induction programme when they started work at the service.

People told us that some staff were caring and that some staff made them feel uncomfortable. Staff we spoke with had a good understanding of how to promote people’s dignity.

When people started to use the service a care plan was developed that included details about their care needs and how to meet those needs. Information about people’s likes dislikes and preferences were included so staff had all of the relevant information, apart from that relating to medicines, to meet people’s needs.

At times care workers did not arrive on time for homecare visits. People felt that they were sometimes rushed by care workers. They told us that the care workers did not always stay for the scheduled period of time.

People told us they knew how to make a complaint. The service had a complaints procedure. The service had not recognised concerns that people raised as possible complaints.

People told us that they completed a questionnaire to provide feedback on the service. They told us that they did not get any feedback from this questionnaire.

Systems were in place for monitoring the quality of care and support provided. These had not been updated regularly and did not reflect all of the checks that had taken place.

The service had a clear management structure in place. Staff told us that they found the management approachable and felt that they were listened to.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.