Archived: Basing Care Limited

Updated 29 June 2016

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 provider is 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 12, 13, and 14 April 2016 and was announced. The provider was given 48 hours’ notice of the inspection to ensure that the people we needed to speak with were available. The inspection team consisted of one adult social care inspector.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with information we held about the service, for example, statutory notifications. A notification is information about important events which the provider is required to tell us about by law. We also reviewed the provider’s website.

During the inspection we spoke with the registered manager and the provider’s area manager who has overall responsibility for supervising the management of the service. We also spoke with the care coordinator, a team leader, a senior care worker and 14 staff.

We visited eight people in their homes and also spoke with seven staff in attendance. We spoke with people and their relatives about their care and looked at their care records. We observed some aspects of care, such as staff preparing people’s meals and supporting them to move. Following the home visits we spoke with three health and social care professionals. We spoke with a further 10 people on the telephone to find out about their experience of the quality of care provided by the service.

We reviewed 19 people’s support plans, including daily records and medicines administration records (MARs). We looked at ten staff recruitment files, and reviewed the provider’s computer training records. We reviewed the provider’s policies, procedures and records relating to the management of the service. We considered how comments from people, staff and others, as well as quality assurance audits, were used to drive improvements in the service.

This was the first inspection of the service since it was taken over by the new provider in May 2015.

Updated 29 June 2016

This announced inspection took place on 12, 13 and 14 April 2016. Basing Care Limited provides a domiciliary care service to enable people living in Basingstoke and the surrounding areas to maintain their independence at home. At the time of our inspection there were 120 people using the service, who had a range of health and social care needs. Some people were being supported to live with dementia, whilst others were supported with specific health conditions including epilepsy, diabetes, sensory impairments, multiple sclerosis, motor neurones disease, Parkinson’s disease and mental health diagnoses. At the time of the inspection the provider deployed 47 staff to care for people and meet their individual needs.

The service had a registered manager who was appointed in March 2015. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 2008 and associated Regulations about how the service is run.

In May 2015 the service experienced a phase of transition due to being taken over by a new provider and new commissioning arrangements with the local authority.

People were supported by staff who made them feel safe. People and relatives told us the continuity and consistency of staff had improved since the new provider had taken over and the registered manager had been appointed. People told us they liked to know who was coming to support them in their homes, which reassured them and lessened their anxiety.

People were kept safe and protected from abuse because staff understood their role and responsibility in relation to safeguarding procedures. There had been three incidents since May 2015, which had been referred to the local safeguarding authority. These incidents had been reported, recorded and investigated in accordance with the provider’s safeguarding policies and local authority guidance.

Designated staff completed needs and risk assessments, which promoted people’s independence, while keeping them safe. Risks associated with people’s care and support needs were identified and managed safely to protect them from harm. Risks to people in relation to the provision of their personal care and environmental risks had been assessed and control measures put in place to minimise their occurrence. Staff provided people’s care safely in accordance with the guidance contained within their care plans.

People received a high degree of continuity in the staff providing their care. If people needed two staff to provide their care safely this was rostered and provided. The registered manager ensured they did not overcommit the service and did not accept requests for care which they could not meet safely. People and their relatives had no concerns regarding staffing levels. Staff told us there were always enough staff to provide the required support, which we observed in practice.

Staff had undergone relevant pre-employment checks as part of their recruitment, which had been verified by the provider. People were safe as they were cared for by staff whose suitability for their role had been assessed by the provider.

Staff were able to explain the purpose of medicines prescribed for individual’s health and wellbeing and supported people to understand what their medicines were for, so that people understood the importance of taking their medicines to maintain their health. People received their medicines safely, administered by staff who had completed medicines management training and had their competency assessed by the registered manager.

The provider supported staff to meet people’s needs with an effective programme of induction, supervision and appraisal. The provider’s required staff training was up to date and refreshed regularly to ensure staff had retained and updated the skills and knowledge required to support people effectively. The provider’s allocation system prevented staff being allotted to cover visits if their training had not been completed or needed to be refreshed.

People’s human rights were protected by staff who demonstrated clear understanding of guidance and legislation relating to consent and mental capacity. The registered manager and staff had initiated best interest processes where required to ensure people’s human rights were protected.

People were supported to maintain a healthy balanced diet by staff who understood their dietary preferences. We observed people supported appropriately to ensure they received sufficient to eat and drink.

Staff were alert to people’s changing needs and took prompt action to promote their health and wellbeing by ensuring they were referred to relevant health professionals where required.

Staff had developed caring relationships with people and knew about peoples’ needs and the challenges they faced. Staff understood people’s care plans and the events that had informed them.

People and staff had meaningful conversations which did not just focus on the person’s support needs. Staff spent time to sit and chat with people and always spoke with them in an inclusive manner, enquiring about their welfare and feelings. People were supported by thoughtful staff who treated them with dignity and respect.

People were involved in developing their personalised care plans which detailed their daily routines. People told us the registered manager committed to ensuring people were involved as much as they were able to be in the planning of their own care. There was guidance for staff about how to support people to promote their independence and maximise the opportunity to do things of their choice.

People their relatives and professionals told us the way care was provided reflected people’s preferences. Staff understood the need to enable people to make choices in their daily lives as far as they were able and were active in enabling people to make choices. Staff understood people’s different communication needs and ensured they followed the guidance provided in people’s care plans to enable them to communicate their views.

People’s needs were assessed and regularly reviewed to ensure their care and support was responsive to changes identified. Care plans and regular reviews documented the support and care people required, and how this should be provided in accordance with their wishes. Records accurately reflected people’s needs and were up to date. Staff were provided with necessary information and guidance to meet people’s needs. People’s and staff records were stored securely, protecting their confidential information from unauthorised persons.

People told us they felt able to raise any issues or complaints with staff and that they would be listened to and appropriate action taken in response. Records demonstrated that when any complaints had been received, the manager had investigated them, in accordance with the provider’s policy and responded to the complainant with the actions taken. The service was responsive to people’s feedback.

Staff told us the registered manager was highly visible and regularly went out to provide care, which made them feel part of a team. People and relatives praised the registered manager saying they were very approachable and always willing to listen.

The provider’s values were based upon caring passionately about people, supporting and enabling them to live life to the full, promoting their independence and to deliver personalised services which met their needs. Staff knew these values which we observed them demonstrate while delivering people’s day to day care.

People we spoke to were complimentary about the management of the service. There was a clearly defined management structure in place and the provider had good oversight of the service.

The registered manager effectively operated systems to assure the quality of the service and drive improvements. Feedback from people, their relatives, and staff was sought to identify changes required to improve the quality of care people experienced. The provider’s audits were used to review changes implemented, and ensure all required actions had been taken.