Archived: B&H Care Ltd

Updated 29 December 2016

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.

We undertook an unannounced inspection of B&H Care Ltd on 1 to 3 November 2016. This inspection was completed in response to concerns that had been shared with us about the safety and quality of care. These concerns had been raised by people who used the service and the local authority. We inspected the service against the five questions we ask about services: is the service safe, effective, caring, responsive and well-led? Our inspection team consisted of two inspectors.

We checked the information we held about the service and provider. This included the information we had received from the public and local authority. We used this information to formulate our inspection plan.

We spoke with five people who used the service, five relatives, five members of care staff, the registered manager (who was also the provider) and the care manager (who was also the provider) . We also spoke with two health and social care professionals who visited people who used the service. We did this to gain people’s views about the care and to check that standards of care were being met.

With their consent, we visited people who used the service in their own homes and observed how the staff interacted with them in. We looked at the care records of the five people we visited to see if their records were accurate and up to date. We also looked at records relating to the management of the service. These included staff files and rotas.

Following our inspection we shared our findings and concerns with the local authority. We did this because we identified that people were at risk of immediate harm to their health, safety and wellbeing.

Updated 29 December 2016

We completed an unannounced inspection at B&H Care Ltd on 1 to 3 November 2016. This was the first inspection since the service was registered with us in December 2013.

We identified multiple breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration Requirements) Regulations 2009. The overall rating for this service was 'Inadequate' and the service was therefore immediately placed in 'Special measures'.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

The service is registered to provide personal to people in their own homes. At the time of our inspection six people were using the service.

The service had a registered manager. 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 and associated Regulations about how the service is run.

At this inspection, we found that the registered manager and provider did not have effective systems in place to assess, monitor and improve the quality of care. This meant that poor care was not being identified and rectified by the registered manager or provider.

Risks to people’s health, safety and wellbeing were not identified, managed and reviewed and medicines were not managed safely.

People were not protected from the risk of abuse because suspected abuse was not reported as required.

Safe recruitment systems were not in place, so people could not be assured that the staff were suitable to support them in their own homes.

Staff were not effectively deployed, so care calls were frequently late which impacted on people’s health and wellbeing.

People did not always receive their care in line with their care preferences and their care needs were not regularly reviewed. People’s care plans were not accurate and up to date which meant staff didn’t always have the information they needed to provide safe and consistent care.

Staff did not have the knowledge and skills required to meet people’s individual care needs and keep people safe. People’s health was not effectively monitored and managed to promote their health and wellbeing.

People were not always treated with dignity and their rights to make choices about their care were not always respected. People told us they sometimes received care they had not consented to.

The requirements of the Mental Capacity Act 2005 were not always followed to ensure people decisions about care were being made in people’s best interests when they were unable to make these decisions for themselves.

Effective systems were not in place to ensure concerns about the quality of care were recorded, investigated and managed to improve people’s care experiences.

The registered manager and provider were in breach of the conditions of their registration with us as they were operating the service from an unregistered location. The registered manager and provider did not notify us of reportable incidents and events as required.