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Julie Blackburn Homecare Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 24 July 2018

Our inspection of Julie Blackburn Homecare Limited took place on 5 and 20 June and was announced. The service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older people, people with physical disabilities, sensory impairment and people living with dementia. At the time of our visit the service provided personal care to 29 people.

The provider was also the registered manager for the service. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

At the last inspection we rated the service as ‘Good’ and there were no breaches of relevant regulations. However, on this inspection we found three breaches of regulation. There was a lack of record keeping in relation to quality audits and the driving forward of continuous improvements. The staff team felt supported through supervisions and team meetings but these were not formally recorded or minutes taken. We also found that a failure to have protocols in place for ‘as and when required medication’ and details within people’s care plans about the medicines that they needed to receive. This is a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; Good Governance due to a lack of records.

We identified two events that should have been notified to CQC but had not been. This was a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

Despite the breaches of regulation, we found there was a positive culture within the service; people were treated with dignity and respect and were supported to make their own decisions. Care plans demonstrated the basic principles of the Mental Capacity Act (MCA) 2005 and we observed this being applied in practice.

Care plans demonstrated a commitment to person centred care and risks to people were assessed and managed. Care and risk plans were reviewed and the service worked in partnership with external agencies to meet people’s needs. Staff had a good understanding of people's needs and were kind and caring. They understood the importance of respecting people's dignity and upholding their right to privacy.

Staff had access to training and plans for future training were in place. The registered manager carried out spot checks to ensure staff were competent in their roles. The manager also worked side by side with the staff on a daily basis which enabled them to be at the forefront of the care provided to the people who used the service. Staff felt supported in their role. We made a recommendation about formal supervision and appraisals.

Recruitment processes were in place and were robust and there was sufficient staff to meet people’s needs. People confirmed they received care and support from regular staff who they knew. Staff understood what action to take to safeguard people from abuse and training about this was provided.

People’s nutritional needs were catered for and the level of support provided was dependant on people’s abilities. Staff told us how they worked alongside people to prepare their own meals where they were capable.

The registered manager recorded incidents and accidents on specific concerns forms to enable monitoring and reflection on events. There had been very few since the last inspection but all instances were reflected upon and provided examples of lessons learnt.

People were protected from the risks of cross infection because staff used personal protective equipment followed appropriate infection prevention and control best practice.

There was a complaints procedure in place which allowed people to voice their concerns if they were unhappy with the service they received. There were no active complaints at the time of the inspection. We saw historic complaints had been dealt with promptly and appropriately.

The service didn’t record people’s end of life preferences however staff attended end of life training and the provider told us they will consider recording people’s preferences moving forward.

Inspection areas

Safe

Requires improvement

Updated 24 July 2018

The service was not always safe.

People received their medication safely but audit checks were not in place and further information regarding people’s medicines was required.

Recruitment checks in place were robust.

People were safeguarded from the risk of abuse through the training, policies and procedures and knowledge of staff. Although we found one example where a notification had not been submitted.

People had individual risk management plans in place to help keep them safe.

Effective

Good

Updated 24 July 2018

The service was effective.

People’s needs were assessed and they were supported by staff who had the skills and the knowledge to assist them.

Care plans took into account the principles of the Mental Capacity Act 2005. This was applied in practice.

Staff said they felt supported in their role.

People were supported to maintain good health and had access to healthcare professionals and services.

Caring

Good

Updated 24 July 2018

The service was caring.

Positive feedback was received from people who used the service, relatives and professionals. They commended the caring nature of the staff.

Staff had a good understanding of people’s needs and were able to provide person centred support.

People’s rights to privacy and dignity were respected.

Responsive

Good

Updated 24 July 2018

The service was responsive.

People received person centred care which focused on their individual needs.

People and their relatives knew how to raise concerns and were confident the registered manager would listen and address them.

Well-led

Requires improvement

Updated 24 July 2018

The service was not always well-led.

A lack of record keeping meant that there was no evidence of a commitment to continuous improvement and quality assurance.

Two notifications had not been reported to CQC.

The provider listened to, and acted on, feedback from people, their relatives and members of the staff team.

The provider had positive relationships with other professionals.