Archived: Bliss Support

Updated 3 May 2017

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 17 and 24 January 2017. Both days were announced. The provider was given 48 hours notice for the first day and 24 hours notice for the second day. The inspection team was comprised of one inspector and one specialist adviser in governance. In addition, on the second day of the inspection, an inspection manager attended.

We looked at all of the key information we held about the service which included notifications. Notifications are changes, events or incidents that providers must tell us about.

We spoke with three people using the service at the agency’s offices on 17 January 2017. We spoke with a further three people using the service and one relative by telephone following the first day of the inspection visit. We looked at five people’s care and support plans. We reviewed other records relating to the support people received and how the service was managed. This included some of the provider’s checks of the quality and safety of people’s care and support, staff training and staff recruitment records. We spoke with ten staff, including the registered manager, service co-ordinator and care and support staff. We also spoke with four health and social care professionals by telephone following our visit.

Updated 3 May 2017

Bliss Support provides personal care for adults in their own homes. This includes people living with brain injury. There were nine people using the service for personal care at the time of our inspection.

This inspection took place on 17 and 24 January 2017. The service is run from an office in Hasland, Chesterfield and provides care to people in north Derbyshire. The provider was given 48 hours' notice because the location provides a domiciliary care service and we wanted to make sure there was someone available. We spoke with three people at the agency’s offices on the first day of the inspection. In addition, we also carried out telephone calls to a further three people using the service, one relative and five staff on 18 and 19 January 2017.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

There was a registered manager at the service. 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.

The leadership of the service was ineffective. The registered manager had not provided information as requested both before and after the inspection visit. Some records we requested were not available on either day of the inspection visits. Systems to monitor the quality of the service were incomplete and disorganised and had not identified where improvements were required. The provider’s website contained misleading information and did not ensure people could make an informed choice about using the service.

The provider's arrangements for staff recruitment and deployment were unsafe and did not ensure suitable people were employed. There were insufficient staff at times and some were working excessive hours.

Support for staff was insufficient due to infrequent training and a lack of induction and supervision.

People’s assessment records were up to date but other aspects of their care records had not been updated and some people had not had their care reviewed for over two years. People were not consistently involved in reviews of their care.

Medicines were generally safely managed.

People were safeguarded from abuse because the provider had relevant guidance in place and staff were knowledgeable about the reporting procedure.

Staff understood their roles and responsibilities for people's care and safety needs and for reporting any related concerns.

The principles and requirements of the Mental Capacity Act (2005) were being met. People were supported by staff who knew them well. Staff were aware of promoting people’s safety, whilst providing information to support people to make day-to-day decisions.

People received appropriate support to manage their meals and nutrition when required. This was done in a way that met with their needs and choices. People’s health needs were met. Referrals to external health professionals were made in a timely manner.

People and their relatives told us the care staff were caring and kind and that their privacy and dignity was maintained when personal care was provided. They were supported to participate in leisure pursuits of their choice.

Complaints were managed satisfactorily.

We identified five breaches of Regulations. You can see what action we took at the end of this report.