Archived: Breckland Care at Home

Updated 6 June 2018

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.

This inspection took place on 14 March 2018. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be available in the office.

The inspection team consisted of one 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. The expert by experience telephoned people for their feedback regarding the quality of care they received. The inspector visited the provider’s office.

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 home, what the service does well and improvements they plan to make. We also reviewed other information that we held about the service such as notifications the provider had sent us. Providers are required to notify the Care Quality Commission about events and incidents that occur including unexpected deaths, injuries to people receiving care and safeguarding matters.

Prior to the inspection we sent questionnaires to 20 people using the service, and their relatives. Nine people and three relatives replied. Due to this small sample, the information supplied by people and their relatives is not contained within this report but their feedback was used to help us plan the inspection.

During the inspection, we spoke with nine people and one relative, six staff, the registered manager and two representatives of the provider. We looked at four people’s care records, three people’s medicine records, three staff recruitment files, staff training records and records in relation to how the provider and registered manager monitored the quality of care people received.

Updated 6 June 2018

This was an announced inspection that took place on 14 March 2018.

At our last inspection in December 2016, we found that the quality and safety of the care provided to people required improvement. We identified that the provider had been in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) 2014. This was because risks to people’s safety had not always been assessed appropriately and there were a lack of robust governance systems in place to monitor the quality of care people received. After that inspection, the provider sent us an action plan telling us what they were going to do to improve the quality of care people received.

Since our last inspection the provider of the company has changed and at this inspection, we found that sufficient improvements had been made and that the service was no longer in breach of any regulations. The overall rating for this service has now changed from Requires Improvement to Good.

This service is a domiciliary care agency. It provides personal care to people living in their own homes. At the time of the inspection it was providing care to approximately 50 people.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission 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.

People’s individual care needs and preferences had been assessed. However, the information contained within people’s care records was not sufficient to guide staff on how to meet these needs. Therefore improvements are required within this area to reduce the risk of people receiving inappropriate care.

We have also made a recommendation regarding the manager and provider familiarising themselves with the Accessible Information Standard. This standard was put in place in 2012 to ensure that people had access to appropriate information to meet their individual communication needs.

The people we spoke with told us they received the care they required and that this met their needs and preferences. The provider had ensured there were enough staff to do this.

Staff had received sufficient training and support to make sure they could provide people with safe and effective care. People received their medicines when they needed them.

Staff used good infection control techniques to reduce the risk of spreading infection and risks to people’s safety had been assessed and managed well. People’s consent was sought before staff completed a task and where required, were supported to eat and drink enough and with their healthcare needs.

The staff were kind, caring and compassionate and people were empowered to have control of the care they received. People were treated with dignity and respect. People’s concerns and complaints were listened to and investigated but a record of these was not always made which may help the provider identify any patterns in relation to care delivery.

There was an open culture where people, relatives and staff could raise concerns without fear. The provider had a clear vision to ensure the delivery of care met people’s individual needs and we found this to be the case.

Systems were in place to monitor the quality of care people received. Where shortfalls were found, actions had been taken and lessons learnt where appropriate. People and staff were encouraged to give their views regarding the running of the service to drive improvement.

People were happy that the service was run well but the staff had mixed views about this with some saying they felt very valued and supported but others saying this was not the case. The provider said they were actively working on fully engaging staff within the business.