21 February 2019
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 registered 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.
The inspection took place on 16 and 22 January 2019. To make sure key staff were available to assist in the inspection, the registered provider was given short notice of the visit, in line with our current methodology for inspecting domiciliary care agencies. An adult social care inspector carried out the inspection.
To help us to plan and identify areas to focus on during the inspection we considered all the information we held about the service, such as notifications sent to us by the registered provider and information from people who contacted us to share their experiences. We also requested the views of other agencies that worked with the service, such as service commissioners.
Inspection activity started on 16 January 2019 and ended on 22 January 2019. We visited the office location on 16 January 2019 to meet the registered manager and two care coordinators and to review care records and policies and procedures. On 16 January 2019 we also visited one person in their own home and observed care and support. On 22 January 2019 we spoke with two people who used the service and three relatives. We also spoke with three care workers to gather their views about the support provided.
We looked at the system for arranging visits to people and documentation relating to people who used the service, staff and the management of the service. This included checking three people’s care records, how complaints and concerns had been managed, staff recruitment, training and support documentation, and the quality assurance systems, to check if they were robust and had identified areas for improvement.
21 February 2019
The inspection took place on 16 and 22 January 2019 with the registered provider being given short notice of the visit to the office, in line with our current methodology for inspecting domiciliary care agencies. At our previous inspection in May 2016 the service was given an overall rating of ‘Good’. At this inspection we found it remained good.
Bramhams Homecare Ltd. is a domiciliary care agency which provides personal care to people living in their own houses and flats in the community. The agency currently caters for people whose main needs are those associated with older people, including people living with dementia. At the time of our inspection 16 people were receiving personal care from the service.
The service had a registered manager in post at the time of our inspection. 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.
People we spoke with were happy with the quality of the care the service provided and how it was run. They told us the care workers were very good and met their needs and delivered their care as they wanted it delivering.
Staff had been trained in safeguarding of vulnerable people from abuse and avoidable harm. Staff were knowledgeable about the potential risks and signs of abuse. Risks to people's safety and wellbeing were assessed and managed in the least restrictive way possible. There were sufficient suitably trained staff available to meet people's needs. People's medicines were safely managed. Staff had received training in infection control practices and personal protective equipment such as gloves and aprons was provided for them.
The management and staff team used incidents as a learning tool to help further ensure people's safety and wellbeing. Staff received training and supervision to enable them to meet people's care and support needs. The service worked within the principles of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People had consented to their planned care and staff understood the importance of gaining people’s consent and acting in their best interest. People were supported to eat and drink sufficient amounts to maintain their health and wellbeing. The staff and management team worked in partnership with external agencies to ensure people’s needs were identified and met.
People had a small team of staff who supported them which helped to ensure continuity and enabled people to form bonds with the staff. Staff understood the importance of promoting people's independence and respecting their dignity. People's care records were stored securely to help maintain their dignity and confidentiality.
People and their relatives had been involved in developing care plans that addressed all areas of people's lives. Staff were matched as far as possible with the people they supported in terms of gender, interests and skills. People were enabled to raise complaints and concerns. The people we spoke with told us they would feel comfortable raising concerns, if they had any. When concerns had been raised the correct procedure had been used to record, investigate and resolve issues.
There was a range of routine checks undertaken by the management team which were effective in identifying shortfalls. The management team were passionate about providing good care and support and demonstrated an in-depth knowledge of the staff they employed and people who used the service.
People had been given opportunities to share their opinions about their service provision and action had been taken to address areas for improvement.
Further information is in the detailed findings below.