Archived: Better Healthcare Services (Colchester)

Better Healthcare Colchester is a domiciliary care agency. The service provides personal care to people living in their own homes in the community. At the time of this inspection, the service provided support to 132 people.

People’s experience of using this service and what we found

People were not always safe using the service as missed and late calls meant people were being left without the care they needed. People were not always safeguarded from poor care as there were not enough staff to care for people using the service.

Risk assessments did not provide assurances people were receiving the care they required, and, in the way, they needed it. Risks to people’s safety had not been reviewed or care plans updated with their up to date needs.

People’s medicines were not always given at the time prescribed. The lack of available information, regular audits and analysis of errors meant we could not be assured people received their medicines safely to manage their physical and/or mental health needs.

The service had not been consistently managed and there had been lack of clear management oversight. The role and responsibilities of office-based staff were not robust and clear for them to carry out their roles well. Quality assurance processes were not in place for the safety of the service and the management of records was disorganised.

Systems to control and prevent the risk of infection were in place. The service worked in partnership with other agencies and professionals for the benefit of people they supported.

Rating at last inspection

The last rating for this service was good (published 21 December 2018).

Why we inspected

The inspection was prompted in part due to concerns received from members of the public, staff and the local authority about risks to people’s health and safety, late and missed calls and staffing issues. A decision was made for us to inspect and examine those risks.

We have found evidence the provider needed to make improvements. Due to the nature of the concerns, we only inspected the key questions of safe and well led. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We found three breaches of the Health and Social Care Act 2008 in relation to safe care and treatment, staffing and good governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

•Staff had a good knowledge of how to keep people safe from avoidable harm.

•People were supported to take their medicines in a safe way, but staff did not always have guidance on when to give medicines that were prescribed ‘as and when required’

¿Staff were recruited safely and appropriate checks were carried out before they started work at the service.

¿Where lessons were learned, feedback was provided to staff to ensure continuous improvement took place throughout the service

¿Quality assurance processes were in place to ensure the safety of the service and these supported the safe running of the service

¿The Registered Manager ensured that staff received specialist training based on people’s individual needs.

¿People received care and support based on their individual assessment, needs and preferences.

¿Staff continued to have a good understanding of key pieces of legislation and when they should be applied.

¿People were supported by staff who understood the need to ensure person centred care and to respect and listen to people. The Registered Manager ensured consistency in staffing to enable positive relationships between staff and people

¿People told us they felt well cared for by staff who treated them with respect and dignity and encouraged them to maintain relationships and keep their independence for as long as possible.

¿ Systems were in place for people to raise complaints and concerns.

¿Staff liaised with other health care professionals to ensure people's safety and meet their health needs.

¿Staff spoke positively about working for the provider. They felt well supported and could talk to management at any time, feeling confident any concerns would be acted on promptly.

More information is in the full report

Rating at last inspection: Good (report published 12 July 2016)

About the service: Better Healthcare Services is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing. It provides a service to older adults

The service also provides 24-hour care within people's homes. Better Healthcare Services serves the people within and around Colchester. At the time of our inspection the service was supporting 65 people and employed 36 members of staff.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If we receive any information of concern, we may inspect sooner.

Better Healthcare Services provides a variety of care and support to people in their own homes. This includes supporting people with personal care needs, shopping, cooking, and companionship. The service also providers 24 hour care within people’s homes. Located in Colchester town centre, Better Healthcare Services serves the people within and around Colchester. At the time of our visit the service was supporting 83 people and employed 43 members of staff.

The service has a registered manager in place. 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 service has been rated as Good in each of the five domains, with an overall rating of Good.

The registered manager and management team communicated appropriately with other organisations and within the guidance set out with the Registration Act 2009.

People using the service could be confident that visits to provide care and support met their needs in a timely manner.

The service provided safe care. Managers responded to concerns about care standards in a timely way. People using the service could be assured that staff had been through a rigorous employment process. Care teams were chosen to ensure consistency of care and competence in care delivery. Care workers followed safeguarding procedures appropriately, and had used whistleblowing procedures to protect people.

The service took seriously the need for care workers to be trained to deliver safe, effective care in a caring manner. Care practices were monitored through regular observations, and when needed care workers would receive additional training. Comprehensive risk assessments were completed and regularly reviewed so that people’s changing needs could be identified, and staff had a good understanding of infection control and were provided with the appropriate clothing and protective wear.

People who used the service described care staff and managers as kind and caring. Care workers knew people’s individual, diverse cultural, religious and gender needs and preferences, and had developed positive relationships with people and provided care that was respectful and dignified.

Care workers were responsive to people’s needs. People were supported by a small number of core staff which meant that care workers had been able to develop positive relationships with people. When people’s needs changed, care workers notified the registered manager and communicated with other health professionals in order to ensure people received the right care and treatment.

People using the service could be confident that when they complained about standards of care from care workers their concerns would be acted upon quickly and sensitively and they would be informed of the outcome. However, whilst we saw that complaints immediately addressed issues arising from complaints, these were not always used to drive service improvement.

People at the service and care staff told us that the management team was visible, supportive, and approachable. The registered manager ensured that staff at the service were trained and appropriately supervised and when issues were reported by people regarding staff at the service, were quickly resolved. The service had appropriate quality assurance processes in place to ensure the quality of care provided.