Archived: Brown Clee Domiciliary Care Agency

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People who used the service told us they felt safe because their rights and dignity were respected and they were involved in making decisions about any risks they may decide to take in their daily lives. One person said, 'I feel really safe when the staff are with me.'

The staff and the provider understood the requirements of the Mental Capacity Act 2005, its main Codes of Practice and put them into practice to protect people. This meant that people who used the service were protected from harassment, avoidable harm, abuse and breaches of their human rights.

The provider's aim with medicines management was to prompt and remind people to take their prescribed medicines. The provider maintained records to show that people were supported to administer their own medicines safely.

People were protected from acquired infections because staff demonstrated that they understood their roles and responsibilities in relation to infection control and hygiene. Where necessary the service escalated concerns that impacted on people's health

and wellbeing to appropriate external agencies. The service maintained and followed policies and procedures in line with current relevant national guidance.

Is the service effective?

People told us that they could express their views about their health and quality of life. They said these were taken into account in the assessment of their needs and the planning of the service. People told us they had been involved in the assessment of their needs prior to accepting care from the agency. The care records we looked at reflected people's current individual needs, choices and preferences.

We saw that referrals were quickly made to relevant health services when people's needs changed. For example, referral to the GP or district nurse. This meant that people's health was regularly monitored to identify any changes that may require additional support or intervention.

Is the service caring?

People told us that they were treated with kindness and compassion and that their dignity was respected when receiving personal care. People explained how their individual needs were met, including needs around age and disability. Staff we spoke with knew the people they were caring for well, including their preferences and personal histories. This meant that caring, positive relationships were developed with people living in their own home. Comments from a satisfaction survey stated, 'The essential word about them is 'care' and they really do that.' Another person said, 'They show so much compassion.'

Records were stored in the office so that people were assured that information about them was treated in confidence. Staff we spoke with described how they promoted respectful behaviour and positive attitudes. We were shown records that showed staff had been trained in policies and procedures and how to respect people's privacy, dignity and human rights in their home. This meant people's privacy and dignity was respected and promoted.

People and those that mattered to them were encouraged to make their views known about their care and support, and these were respected. This meant people were listened to and felt that they mattered.

Is the service responsive?

People said that they and their family were encouraged to make their views known about their care and support. Care records detailed how people's individual needs were regularly assessed and met. The way staff talked about people showed that they actively sought and listened to people's views and decisions. This meant people were supported to express their views and be actively involved in making decisions about their care and support.

The provider considered the activity preferences of people so that they could assist them to lead a meaningful life in their home environment. This meant people could still access activities that were important and relevant to them and they were protected from social isolation. People were very much enabled to maintain relationships with their friends and relatives. Staff we spoke with recognised the risks of social isolation and loneliness with people. Staff worked hard to balance the risk against this and how they wanted to live their life. This meant that people received personalised care that was responsive to their needs. One person told us, 'They put in extra care at short notice and that really set my mind at ease.'

Is the service well-led?

Discussion with the provider and staff showed there was an emphasis on fairness, support, transparency and an open culture in the service. The provider operated a clear set of values that included involvement, compassion, dignity, respect, equality and independence which were understood by all staff we spoke with. This meant that the service promoted a positive culture that was person centred, open, inclusive and empowering.

Quality assurance was in place and used to drive improvement. There were effective arrangements to continually review health and safety in people's homes, safeguarding concerns, infection control and food hygiene. Comments from a satisfaction survey included, 'So professional and caring,' and 'The survey question results didn't really reflect what I thought about them enough, they are 100% angels.'

The provider had links with organisations that acted as sources of best practice. For example, for infection control and end of life care. This meant that the registered manager demonstrated good management and leadership.

People considered they had the same staff to meet their current needs which they liked. They said, 'We know who is coming and are never left waiting for them to arrive'. People considered staff were well trained to do their job.

People told us they were regularly asked if their service was satisfactory. They confirmed formal surveys were in place to gain their views about their care or how the service was run.

The provider acknowledged the need to audit the service more robustly. However, the systems in place enabled them to identify problems swiftly and act upon them to keep people safe at all times.