Background to this inspection
Updated
19 May 2023
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 Health and Social Care Act 2008.
Inspection team
The inspection was conducted by two inspectors, a CQC bank inspector, and 3 Experts by Experience. An Expert by Experience is a person who had personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 72 hours’ notice of the inspection. The provider was given notice because the location provides a large domiciliary care service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. We also needed to ensure appropriate consent had been obtained from people and staff we spoke with for us to have their contact details.
Inspection activity started on 21 February 2023 and ended on 27 February 2023. We visited the location’s office on 21 February 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the Provider Information Return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also reviewed additional information we held about the service, this included previous inspection reports and statutory notifications. A statutory notification contains information about certain incidents and events the provider is required to notify us about by law. We used all this information to plan our inspection.
During the inspection
We spoke with the provider and the registered manager during our visit to the locations office. We reviewed a range of records including records relating to the care and support provided to people. We reviewed records which included staff files in relation to recruitment, and various audits/reports relating to the quality and safety of the service. We requested a variety of records were sent to us relating to staff training and regarding the management of the service.
After the inspection
After our visit we continued to seek feedback from people using the service, relatives and staff to obtain their views of the service provided to people. We spoke with 59 people who either used the service or were relatives/representatives of people and were acting on their behalf. We communicated with 18 staff via email about their experience of working for The Bay Care Group and spoke in person with 5 others. We also contacted 7 healthcare professionals and received feedback from 6 of them. We continued to seek clarification from the provider to validate evidence found.
Updated
19 May 2023
About the service
The Bay Care Group is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to younger and older adults. Not everyone using The Bay Care Group received a regulated activity. CQC only inspects the service being received by people provided with ‘personal care', for example help and support with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
The service operated a number of different teams commissioned in partnership through the relevant local authority. The service had a ‘Rapid Response Team’, an ‘Urgent Response Team’, a ‘Peripatetic Night Team’, a ‘Reablement Team’, a ‘Care Home Team’ and a ‘Living Well at Home Team’. All of these teams operated separately within the service with both administrative and care staff allocated to each specific team.
At the time of this inspection, the service provided personal care to approximately 305 people, however due to the business model of the service this number continually changed. People who used the service lived in Torbay, Paignton, Newton Abbot and the surrounding areas. At the time of the inspection, the service delivered a total of approximately 1200 daily care visits which amounted to approximately 34,000 care appointments every 4 weeks.
People’s experience of using this service and what we found
Most of the people we spoke with commented positively on the care they received and the staff that supported them. We received some less positive feedback about people not being supported by care staff of the same sex and appointments times not being in line with people’s preferences.
We spoke with the provider and registered manager about these points. They told us that people received their care in line with the commissioned package funded by the local authority and records they held supported this. They told us that at the commencement of a care package, people were advised of their commissioned appointment timeframes and also that care could be delivered by either male or female care staff.
We saw contracts that people signed at the outset of a care package showed that care could be provided by male or female staff and the contracts also highlighted that on occasions, circumstances out of the providers control may result in appointment being late. The provider also told us people were able to decline accepting the package of care commissioned for them if they were unhappy with the proposed contract.
The provider and registered manager remained committed to recruiting a diverse workforce of both male and female staff from both within the United Kingdom (UK) and internationally. Internationally recruited staff were subject to pre-employment checks and language assessments prior to coming to the UK. Where required, additional support was given to internationally recruited staff through a mix of in-house training, the use of technology such as translator earpieces and additional language classes through local educational facilities.
Staff demonstrated an understanding of safeguarding and were able to identify what might constitute abuse and the reporting process they needed to follow to escalate concerns. Staff were confident any concerns raised would be handled effectively by the service management. One person told us, “They really look after me. They always leave me comfortable. I'm very happy with all my care.”
People’s individual and environmental risks were identified and care was planned in a way to reduce identified risks. The provider worked in partnership with Devon and Somerset Fire Service to reduce fire risks in people’s homes and care plans contained information around a national police missing persons protocol.
People had variable needs around their medicines and told us how they received different levels of support. The provider operated an electronic medicines system which sent alerts to the locations office when an administration had not been completed as prescribed. This allowed immediate action to be taken to establish why an administration had not happened.
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.
Staff had access to Personal Protective Equipment (PPE) such as gloves, aprons and face masks. People we spoke with told us staff wore PPE. One said, “They do wear PPE and some still wear masks as well.” There were systems to ensure that staff compliance with PPE and infection control practice was monitored through quality assurance visits and spot checks.
Most people we spoke with told us that staff treated them with privacy and dignity. A relative said, “Yes, very good, they are lovely with her.” Another told us, “They treat her with respect and always talk [person’s name] through everything. They are just very patient with her.” Staff we contacted understood the importance of promoting people’s privacy and gave examples of how they achieved this.
There were examples of where the service had gone above and beyond in some elements of care provision. This had positively impacted people’s lives. One person had been identified as being at risk of self-neglect through poor personal hygiene. The service adapted the person’s care package to ensure the same member of care staff worked consistently with this person. This build-up of trust resulted in the person showering, changing clothes and increasing their personal hygiene. This evidenced the positive outcomes good care continuity could achieve.
There were systems in place to monitor the standard of care provided by the service. People and staff were invited to give feedback on the service provision. For people using the service, there were quality assurance processes in the form of telephone calls, surveys and home visits. People we spoke with gave mixed responses on the opportunities they had to provide feedback. Some people that did feedback told us there had been no change as a result. From the people we spoke with, this was again primarily based on if they received care from male or female staff.
Whilst some concerns were raised, most of the people when asked told us they would recommend The Bay Care Group to others. One person told us, “I have recommended them already.” Another said, “We are very happy with them and I would recommend this agency.”
Staff we spoke with during the inspection process were overall positive about most aspects of their employment. Nearly all staff asked would recommend The Bay Care Group as a good place to work. Nearly all said they would recommend the service to friends and family for care provision.
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 Outstanding (published 3 May 2018).
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 Outstanding to Good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.