Purple Balm Exeter

About the service

Purple Balm is a domiciliary care agency. The service provides personal care to older and younger adults in Exeter, Newton Abbot and Plymouth areas who may have physical disabilities, learning disabilities or autism, mental health issues or be living with dementia. At the time of our inspection there were 89 people using the service.

Not everyone who used the service received personal care. In this service, the Care Quality Commission can only inspect the service received by people who get support with personal care. This includes help with tasks related to personal hygiene and eating. Where people receive such support, we also consider any wider social care provided.

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

Service provision was monitored on a day-to-day basis, and staff practice monitored through spot checks, supervision, and feedback from people using the service. However, there were no formal auditing process in place to monitor the quality and safety of the service. This meant the failings we found during the inspection had not been identified or action taken to address them.

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; however the policies and systems in the service did not support this practice.

Staff received an induction, training and supervision to support them in their role. However, some staff told us they did not feel valued or supported. The service was registered to support people with a learning disability or autistic spectrum disorder, however relevant training was not provided which is a legal requirement.

Recruitment checks were carried out for staff before they started working at the service to ensure they were safe to work with vulnerable people. However we found some gaps in employment history, which the provider undertook to clarify.

People were at risk of receiving unsafe care because care staff could not access the detailed information in care plans on their hand-held devices. In addition, risk assessments were not always up to date.

There were systems in place to ensure the safe management of medicines, however improvements were needed to ensure peoples allergies were recorded on the computerised care planning system.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were at the centre of their care and were supported to be as independent as possible. Managers and staff empowered people to make their own decisions about their care and support. We received positive feedback from people and family members about the service provided and the positive outcomes people experienced.

People were supported by a consistent team of care staff and there were no missed visits. They told us, “The carers are so kind, trustworthy, happy, punctual and do what is needed. Office staff are lovely.”

People were protected from the risk of abuse and avoidable harm. Lessons learnt from accidents and incidents were used to prevent reoccurrences.

People were supported to live healthier lives, with staff supporting and contacting health care professionals when needed. Staff worked in partnership with other professionals to ensure people received the right support.

The provider was committed to continuing to learn and make the necessary improvements to the quality and safety of the service provided. They welcomed the feedback given during the inspection.

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

Rating at last inspection

The last rating for this service was good (published 6 October 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations:

We have identified breaches in relation to the need for consent, governance and staff training.

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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

Purple Balm (Exeter) domiciliary care agency is a domiciliary care agency which provides personal care to vulnerable adults in the community, the majority living in the Exeter area. The service provision varies from half hourly visits daily to the provision of 24 hour care for people living in their own home. The agency also provides staff to work in residential and other social care settings; however we did not inspect this aspect of the service as there is no requirement for it to be registered. The registered manager told us personal care support was currently being provided to approximately 50 people.

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.

The service was well-led. The registered manager and senior management team was praised for their caring manner, open and approachable management style. Care staff told us they felt well supported, and one member of staff said, “Purple Balm are excellent. I couldn’t fault them. If you have any queries or worries there is always someone at the end of the phone. Whether it’s concerns about a client or personal matters”. There were systems in place to regularly monitor the service and make improvements where necessary, including audits, checks, and satisfaction surveys. Where they identified areas for improvement these were acted upon. People told us the service was very well run, and praised the management team and all the staff. They said, “It’s one of the best agencies”, “They are an amazing company” and, “They are very friendly and very effective”.

People told us they felt safe. They said they received a consistent and reliable service. Purple Balm had a system for identifying the most vulnerable people, which meant their needs would be prioritised if there were any problems affecting service provision. People were protected from abuse and harm because staff had completed training in safeguarding adults, and knew how to recognise and report safeguarding concerns. Purple Balm had worked closely with the local authority and other agencies to report and investigate safeguarding concerns and take any action necessary to keep people safe. Risks to people’s health and safety were well managed. Before people began receiving a service an assessment was carried out to assess any risks to the person using the service and to the staff supporting them. Where people needed assistance with medicines, staff had received training and knew how to support people safely.

Staff had the skills and knowledge to meet people’s needs effectively. Staff received training on a range of topics relevant to the needs of the people who used the service. Staff were well supervised and told us they were well supported. People’s health needs were monitored and prompt action was taken to address any concerns or changes. The service had good links with local health and social care professionals and supported people to seek advice and treatment promptly when necessary.

The service was caring. People were supported by staff who knew them well and understood their needs. We heard many examples of praise for care and kindness of the staff. Comments from people included, “They are very caring staff, they cannot do enough for me” and, “Staff and office staff listen to my needs.” Purple Balm took an active role in the local community, fund raising for charities and organising an information day for older people in the area.

People received a responsive service. People’s needs were assessed and reviewed regularly. A care plan was drawn up with each person before the service started. The care plans contained easy to read and clear information about each task the person wanted support with. The care plans explained how to support and encourage people to remain independent. People were confident they could raise any complaints or concerns with the provider and these would be dealt with promptly and satisfactorily.