Bspoke Social Care

Updated 31 July 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) 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 Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Notice of inspection

We gave 5 days’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider would be in the office to support the inspection. Inspection activity started on 10 June 2019 and ended on 12 June 2019. We visited the office location on 11 and 12 June 2019.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with six people who used the service and two people’s relatives about their experience of the care provided. We spoke with the provider, administrator and two members of care staff.

We looked at three people's care records in full and two people's care records in part. This included medication administration records and people's daily notes. We looked at six staff's recruitment, induction, training and supervision records as well as other records relating to the management of the service.

Updated 31 July 2019

About the service

Bspoke Social Care is a domiciliary care service providing care and support to older people and younger adults, as well as people who may be living with a learning disabilities or autistic spectrum disorder, dementia, mental health needs, or a physical disability.

Not everyone using the service receives regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection 24 people were being supported with personal care.

At the time of our inspection, the service was not providing support with personal care to anyone with a learning disability or autistic spectrum disorder. Non-the-less the service applied the principles and values of Registering the Right Support and other best practice guidance. These principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.

People’s experience of using this service

People were at risk of receiving unsafe or ineffective care. Medicines had not been managed safely; information about people’s needs, risks to their safety and how these risks should be managed had not always been recorded.

New staff completed shadowing to learn how to meet people’s needs, but had received limited formal training or practical training. The provider did not have a robust approach to assessing and evidencing new staff had the skills and knowledge needed to safely support people. Clear and complete records were not always available to show risks had been assessed and managed. More detailed audits were needed to monitor the quality and safety of the service.

We made a recommendation about exploring and recording any wishes and views people had for care and support approaching the end of their life.

People and relatives consistently praised the kind and caring staff. They told us they felt safe with the support staff provided and complimented the person-centred support they received. People enjoyed staff’s company and had developed positive caring relationships with them. Staff understood people’s needs and took account of people’s likes, dislikes and personal preferences when providing care. People’s privacy and dignity were maintained.

New staff were safely recruited. The provider made sure enough staff were deployed and people praised the reliable staff who arrived on time and never missed visits. Staff were supported to identify and respond to any safeguarding concerns.

People were supported to receive medical attention if they were unwell or an accident or incident occurred.

Staff listened to people and followed their instructions. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People felt able to raise any issues or concerns. The provider listened and responded to any complaints about the service.

For more details, please see the full report which is on the CQC’s website at www.cqc.org.uk.

Rating at last inspection

At the last inspection service was rated Good (report published 7 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to the governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.

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.