Background to this inspection
Updated
21 September 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
This inspection was carried out by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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 were 2 registered managers in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 7 March 2023 and ended on 16 March 2023. We visited the location’s office on 7 March 2023.
What we did before the inspection
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We reviewed information we had received about the service since they registered with CQC. This included notifications of events providers are required to tell us about, and information from members of the public about their experience of the service.
We used all this information to plan our inspection.
During the inspection
We spoke with 1 person and 6 relatives of people who used the service about their experience of the care provided. We spoke with the registered manager, the nominated individual (who was also a registered manager) and 7 members of staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also contacted 5 professionals for their feedback about the service. We reviewed a range of records. These included 4 people's care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training records and policies and procedures were reviewed.
Updated
21 September 2023
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
About the service
BeHappy@Home Southampton is a is a domiciliary care agency providing personal care to people who live in their own home. At the time of inspection, they were providing care to 37 people, which included older people, people with a mental health condition and people with a learning disability and/or autistic people.
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
Right Support
We found not all staff had completed the appropriate training for their roles. We also found that people had not always received their medicines as required and this had not been followed up to check for harm. This placed people at risk of receiving inappropriate or unsafe care. There was not a robust effective system in place to ensure the provider employed people who were suitably qualified, competent and experienced. However, the provider was able to correct this during the inspection and obtained the information needed to comply with the regulations.
People had choice and control around their care arrangements. Care focussed on people's abilities and promoted their independence.
People were supported to maintain relationships that were important to them and care was arranged so people could access the services and activities which they wished. People's care plans identified how they would like to be supported and what they would like to achieve with the help of care and support.
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.
Right Care
We identified concerns in relation to staff’s recording of medication administration and training records. We found no evidence people had been harmed. However, there were failures to record, monitor and improve the quality and safety of the service, and a failure to maintain accurate records.
Staff were respectful of people's dignity, privacy and treated them as individuals with their own beliefs, thoughts and aspirations.
People told us they were happy with their care. People or their relatives felt comfortable raising issues or concerns. There were systems and processes in place to safeguard people from abuse. However, although the provider had raised safeguarding’s with the local authority they had failed to notify CQC as required. The provider had an open and transparent approach where people, relatives and professionals were kept informed about key events related to care.
Right Culture
Although we found issues around the oversight of governance, medication and training. From the feedback we received from people and relatives, the registered manager, their staff, and the provider's management displayed caring and person-centred values. They modelled this behaviour to staff and set expectations that these values should be integral to staff's working practice.
People were supported and treated with dignity and respect. Staff used accessible ways to communicate with people which were personalised to meet their needs. Relatives said staff listened to what they had to say and worked with them to communicate appropriately with people and in a way people could understand.
The provider worked well with external stakeholders to meet people's changing needs and ensure people had smooth transitions when moving between different services.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 04 October 2021 and this was the first inspection.
Why we inspected
This was a planned inspection as the service had not previously been inspected.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.