Background to this inspection
Updated
23 April 2022
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 one inspector and two 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 48 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 1 April 2022 and ended on 7 April 2022. We visited the service on 1 April 2022.
What we did before the inspection
We used the information the provider sent us in the provider information return. 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 contacted the local authority for feedback. We used all this information to plan our inspection.
During the inspection
We spoke with six people and 16 relatives about the service they receive. We spoke with the registered manager, team leader and director of care. We received feedback from 12 members of staff including carers, senior carers, team leaders and deputy managers to obtain their views of the service.
We reviewed a range of records. This included four people's care records and multiple medication records. We looked at four staff files in relation to recruitment, induction and training. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We reviewed further documents supplied by the registered manager. These included training data and a medication protocol. We contacted five professionals who work with the service and received feedback from all five. This information helped inform our judgements.
Updated
23 April 2022
About the service
Brunelcare Domiciliary Services Somerset is a domiciliary care service that was providing personal care to 215 people aged 65 and over at the time of the inspection.
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
Since our last inspection people’s care plans had been significantly improved. They included specific details of how staff should work with people to meet their needs. This included how to support people who required modified diets.
People told us the service helped them to feel and stay safe. Their relatives agreed. People’s risks were assessed, recorded and support provided to minimise these without being unduly restrictive.
Most visits happened at the times scheduled although some people had experienced delays due to staff sickness during the COVID-19 pandemic. The service was trialling a new process to ensure better deployment of staff and visit timings. The service had assessed people’s dependency to enable them to prioritise visits in the event of emergencies or unplanned staff shortages. A missed visits protocol had been introduced to ensure robust oversight and follow up where required.
Spot checks took place to ensure staff were competent to support people. A relative told us, “The carers are very professional and my [family member] tends to have a senior carer who has set the high standard for other carers.”
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.
Staff enjoyed their roles and felt proud working for the service. They felt supported by their colleagues. One staff member said, “I love my job, my clients and all the staff there. It's a great place to work.”
Professionals were unanimous in their praise of the service. Strong links had been developed with GP surgeries and reablement teams that were contributing to positive outcomes and goal setting for people.
The service worked closely with commissioners to support people’s timely discharge from hospital and assessment for ongoing care and support. They had also partnered with commissioners, a private company and a selected group of people in a telecare pilot where sensors and health monitoring devices were embedded in their homes.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 4 May 2019).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out a comprehensive inspection of this service on 26 February 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Brunelcare Domiciliary Services Somerset on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.