Bunbury Agency Ltd

Updated 22 July 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 carried out by 1 inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses. This includes 24 hour live-in care and daily care calls.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the 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 reviewed information we had received about the service and we sought feedback from the local authority.

We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service. We spoke with numerous staff members including the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with external professionals.

We reviewed 6 care records, medication records, and 5 staff personnel files in relation to recruitment. We also viewed various records including policies and procedures in relation to the governance of the service and management.

Updated 22 July 2023

About the service

Bunbury Agency Ltd is a domiciliary care service providing care to people in their own home. This care included daily support and live-in support. The agency specialises in providing case management and support and is responsible for recruitment, care planning and monitoring of the care and support provided. All carers are self-employed. At the time of the inspection 12 people were receiving ‘live-in’ support and 25 people were receiving daily support.

Not everyone who used the service received personal care. 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

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support good practice.

Safeguarding policies and procedures were not effective. People were not safeguarded against the risk of abuse. Systems were not in place to ensure referrals were submitted to the Local Authority and people were kept safe. Incidents and accidents reports were not monitored. Management did not demonstrate a clear understanding of safeguarding adults.

There were gaps in the administration of medication which meant we were not assured people were receiving their medication when required. Staff level of competencies were not assessed in line with their company policies and good practice.

Safe recruitment processes were not being followed. Gaps in employment history were not always accounted for.

Care planning was not personalised and people were not involved in the development and ongoing reviews of their care plans. Therefore, we could not be assured care was planned in a way that promoted independence and gave people a choice of how they wanted to be supported.

People’s consent was not always sought when required. This meant some people’s dignity and human rights were not upheld. Management did not demonstrate a clear understanding of the Mental Capacity Act 2005.

Governance systems were not effective, there was no oversight of the care provided. Feedback from both staff and people was not sought. Therefore, this could not be used to drive any improvements to the service.

Staff did not receive supervisions, this meant staff were not provided with regular feedback on their performance and were not provided time to allow them to reflect on the support they were providing.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This service was registered with us on 2 September 2021 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Caring, Responsive and Well led sections of this full report.

Enforcement and Recommendations

We have identified breaches in relation to people’s dignity and respect, safeguarding people from the risk of abuse and how people’s needs were risk managed. Governance systems were also not effective in managing and monitoring the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this time frame and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.