Archived: Braeburn Care Ltd

Updated 25 March 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 was 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 14 February 2017. The provider was given 48 hours' notice of our visit because we wanted to ensure the registered manager was available to support the inspection. The inspection team consisted of one 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. A member of the Care Quality Commission’s (CQC) policy team also shadowed the inspection.

Before the inspection we reviewed the evidence we had about the service. This included any notifications of significant events, such as serious injuries or safeguarding referrals. Notifications are information about important events which the provider is required to send us by law. We also reviewed the Provider Information Return (PIR) submitted by the provider in August 2016. 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.

During our inspection we visited the agency's premises and spoke with the registered manager, the provider and five care workers. We checked care records for 13 people, including their assessments of needs, care plans and risk assessments. We checked four care workers recruitment files and other records relating to the management of the service, including staff training and induction, the complaints log and quality monitoring checks. As some people who received a care package from Braeburn Care were not able to tell us about their experiences, we observed the care and support being provided to four people with pre-obtained consent. During these home visits we were accompanied by a care worker. We also contacted two care workers via telephone after the inspection to gain their feedback.

This was the first inspection of the service since its registration with the CQC.

Updated 25 March 2017

We inspected Braeburn Care on the 14 February 2017. The inspection was announced so that we could ensure people and records we would need to see were available. Braeburn Care is a domiciliary care agency registered to provide personal care for people who require support in their own home. The organisation is registered to provide care to people with a learning disability or autism spectrum disorder, dementia, older people and younger adults. At the time of our inspection Braeburn Care were providing care to 120 people who had a range of needs from old age, dementia and mental health. The service employed over 40 staff members.

There was a registered manager in post. 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 received personal care and support from Braeburn Care told us they were happy with the service provided. One person told us, “The care workers are lovely, like my own daughters. I look forward to them coming and would not like to change a thing.” Another person told us, “They are very good on the caring side, I feel happy with them.”

People were supported with medicine management when needed and care workers had received training on how to administer medicines. However, we found unexplained gaps in Medication Administration Records (MAR) and people’s medicine risk assessment did not always record the level of support required to safely manage their medicine regime.

Risk assessments were in place which considered moving and handling, however, risks associated with diabetes, falls and skin integrity had not consistently been explored or mitigated. We have made a recommendation for improvement.

Training schedules confirmed care workers had received training on the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). Care workers told us how they gained consent from people before delivering care. Consent forms were in place for people to sign to indicate their consent to the package of care and care plan. However, where relatives were signing consent forms, the provider was unable to demonstrate that they had appropriate authority to do so. We have made a recommendation for improvement.

People had individual care plans in place and care workers spoke highly of these. Information was available on the person’s personal history and hobbies and interests. However, on-going work was required to ensure the principles of person-centred care planning were embedded into practice. We have made a recommendation for improvement.

A robust quality assurance framework was not consistently in place. Systems to monitor if care workers were staying the allocated times at care calls was not effective. Where care workers were not staying the allocated time, documentation failed to record the reason why. For example, although a care call was funded for 30 minutes, documentation reflected the care workers only stayed 20 minutes. People and their relatives raised no concerns over the timings of care calls and care workers not staying the allocated time. However, we have made a recommendation about a robust quality assurance framework which governs the running of the care agency.

People receiving support felt safe and well cared for. They were protected from harm because care workers understood the risks they faced and how to reduce these risks. They also knew how to identify and respond to abuse. Care workers were vigilant of people’s health care needs and ensured they had access to health care professionals to maintain their health. Care workers understood the need to share information about changes in people's health.

There were enough safely recruited care workers to ensure the care could be provided. Care workers told us told us they felt supported in their roles and had received training that provided them with the necessary knowledge and skills to do their job effectively.

People were supported by care workers who were passionate about their work. Care workers told us they liked working for the organisation and appreciated that the organisation put people first.

People and relatives told us they felt able to raise any concerns with the registered manager. They felt these would be listened to and responded to effectively and in a timely way. Care workers told us the registered manager and senior staff were approachable and responsive to their ideas and suggestions.

Care workers were described as being caring and kind. Care workers respected people's decisions to make their own choices and supported people to maintain and develop their independence. One person told us, “Care workers enjoy what they do and go the extra mile and are cheerful, friendly and competent.”

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.