Because We Care Northampton

Updated 16 January 2020

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service a short period of notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 21 November 2019 with telephone calls to people and their relatives. We visited the office location on 26 November 2019 and continued with calls to staff on 27 November 2019.

What we did before the inspection

We reviewed information we had received about the service since their registration. We sought feedback from the local authority and professionals who may work with the service. The provider was not asked to complete a provider information return prior to this inspection. 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. We also asked Healthwatch if they had any feedback about this service. This information helps support our inspections. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service and two people's relatives about their experience of the care provided. We spoke with two members of staff and the registered manager.

We reviewed a range of records. This included four people’s care records, medication records and two staff files. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the registered manager to validate evidence found. We looked at training data and quality assurance records.

Updated 16 January 2020

About the service

Because We Care Northampton is a domiciliary care agency providing support to people in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of inspection, four people were receiving personal care support.

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

People were happy with the care they received. Staff treated people well, with kindness and were thoughtful and empowering. However, there were failings in relation to the management, governance and oversight of the service. The registered manager had failed to embed adequate governance structures to effectively review the service to ensure people received safe care and support. Staff did not have adequate training or supervision and the recruitment procedures did not support the safe delivery of care.

Improvements were required to ensure people received safe care. Risk assessments did not cover all of people’s known risks or provide sufficient guidance for staff about how to manage those risks. Opportunities for learning were limited as staff meetings and discussions were not recorded. People did not have regular reviews of their care.

Improvements were required to ensure people’s care plans were consistent and people were given the same opportunities to have personalised support for them; this included the opportunity to express their end of life care wishes.

Staff understood how to report safeguarding matters and people were supported with their medicines adequately. The service offered limited support to people with their nutritional needs however where necessary, this was provided. Staff ensured peoples’ healthcare needs were well managed.

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 always support this practice as mental capacity assessments were not always completed when required.

A complaints system was in place but had not yet been required. People understood they could make a complaint and felt able to do so. The registered manager was keen to ensure people received good care.

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

Rating at last inspection

This service was registered with us on 30/11/2018 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date of registration.

We have found evidence that the provider needs to make improvement. Please see the Safe, Effective, Responsive and Well Led sections of this full report.

Enforcement

We have identified breaches in relation to staff recruitment, training and supervision and the lack of governance in the service.

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.