29 September 2022
During an inspection looking at part of the service
Bespoke Care Services East Dorset Ltd is a domiciliary care agency. It provides personal care and support to people living in their own homes. Not everyone who used the service received personal care. At the time of this inspection 12 people were receiving personal care from the service. 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.
People's experience of using this service and what we found
Governance systems and processes were not effective. We identified shortfalls in recruitment, safeguarding and legal obligations to report events within the service.
Safe recruitment practices were not always followed with appropriate checks not always being completed to ensure that only suitable staff were employed. People may have been placed at a risk of harm from staff members who had not been recruited safely.
Safeguarding concerns had not been raised correctly to the local authority as required by the regulations. This meant safeguarding concerns were not always known, investigated and corrective and/or preventative action taken which placed people at potential risk of harm.
Providers are required to notify CQC of significant incidents and events. CQC notifications had not been completed and sent to CQC as required by the regulations.
We discussed our findings with the registered manager, who immediately following the inspection, addressed the shortfalls identified and ensured recruitment practices were safe and thorough, safeguarding incidents were reported correctly and CQC notifications were made to CQC as required by the regulations.
People and their relatives told us they were happy with the support they received from Bespoke Care Services East Dorset Ltd. People said they were kept informed of any changes and felt involved in their care. Staff knew people well and delivered care and support to people in ways they preferred, respecting their choices and wishes.
People had risk assessments completed for them. These were then used to develop person centred care plans which guided staff on how to care for people safely. Care plans were individualised, detailed and regularly up dated to ensure people received effective care and support. Staff liaised with health and social care professionals if they needed further guidance regarding people’s health.
Staff received an appropriate induction and were well supported through a programme of regular supervision and training.
Medicines were managed and administered safely. People were supported to take their medicines safely by staff who had received training to administer medicines.
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.
People received personalised care which was responsive to their individual needs. Staff had a good understanding of the care and support people needed and provided this with kindness and care, whilst respecting their privacy and dignity. People received their care from a small, consistent team of care staff who knew people’s care and support needs well.
The service involved people and their families with people’s day to day care and support needs. Relatives and people felt listened to and were consulted about how they preferred to receive their care and support.
People felt the service was well led, friendly and caring. Staff felt well supported in their roles and appreciated the open and supportive approach taken by the management team.
Rating at last inspection
This service was registered with us on 8 October 2021 and this is the first inspection.
Why we inspected
This inspection was prompted in part due to concerns received about recruitment procedures. A decision was made for us to inspect and examine those risks by a review of the information we held about the service.
Following the inspection the provider took immediate action to address the shortfalls and mitigate the risk to people.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We are mindful of the impact of the Covid-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to recruitment, safeguarding, notifications and governance.
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.