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Birchwood Homecaring Services Limited Good

Inspection Summary


Overall summary & rating

Good

Updated 16 October 2018

Birchwood Homecaring Service is a domiciliary service providing personal care to vulnerable older people and younger adults in their own home. The service’s is run from an office located in the market town of Ripley, Derbyshire and provides level access for people.

Not everyone using the service received a regulated activity. CQC only inspects the service being received by people provided with ‘personal care’; such as help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

At our last inspection in November 2016, the service was rated as ‘Requires Improvement.’ This was because people were not fully protected from risks associated with unsafe, or ineffective care and treatment and complaints handling was not always effective, to ensure care improvements when needed. These were respective breaches of Regulations 12 and 16 of the Health and Social Care Act (Regulated Activities) regulations 2014. Following that inspection, the provider told us what action they were taking to rectify the breaches. At this inspection we found the required action was taken by the provider. Related care and service improvements were made to the standard of ‘Good.’

We carried out this inspection on 4, 12 and 27 July 2018. There were 199 people using the service when we visited the provider’s office on 4 and 12 July; during which we spoke with staff. We spoke with people and relatives on 27 July 2018. The provider was given 2 working days’ notice of our inspection as we wanted to make sure the registered manager was available to support our inspection.

There was a registered manager for 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 personal have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People received safe care and support from staff who were safely recruited. The provider’s revised staffing, related management arrangements and risk management strategies for people’s care, helped to fully ensure this. The provider’s emergency and safeguarding contingency measures were revised and followed when required.

Potential risks to people’s safety relating to their health conditions or from unsafe care practice were regularly assessed, monitored and effectively accounted for. Staff understood any related risks and the care steps or reporting procedures they needed to follow for their mitigation. People were consistently and safely supported by staff, including to receive their medicines when required. This helped to ensure people were protected from the risk of harm or abuse.

People received effective care. Revised care planning measures helped to consistently ensure people’s care met with their assessed needs and choices. Staff understood people’s health conditions and followed their related personal care needs to help maintain their health and nutrition. This was done in consultation with relevant external health professionals when required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff were trained and supported to help ensure this.

People continued to receive care from staff who were kind and caring. Staff followed the provider’s stated care principles and understood what was important to people for their care. This helped to ensure people’s dignity and rights when they received care.

People were informed and involved to agree and know what to expect from their care, and to access relevant advocacy if they needed to. Measures were implemented by the provider, to ensure people were provided with accessible care and service information, which they could understand.

Overall, people received timely, individualised care, which was agreed and regularly reviewed with them or their representatives when required. Revised management measures were recently introduced, which helped to ensure this. Staff knew how to communicate with people in the way they understood and followed people’s views and wishes for their care; which were shown as agreed with people in their written care plans. This helped to promote people’s inclusion and independence.

Revised complaints handling measures were introduced. People and relatives were informed and confident to raise any concerns or to make a complaint about their care if they needed to. The provider sought, listened and took better account of people’s views and any complaints; to help determine and make care improvements when required.

People received informed personal care, to help ensure they experienced a personalised, comfortable and dignified death in their own home as they chose, when required.

The service was well led. People, relatives, staff and external care professionals were now confident of this. Revised management, communication and staffing measures were introduced, to improve the safety and effectiveness of people’s care and their related care experience.

Staff understood and followed their role and responsibilities, which helped to ensure people received safe and effective care. Records relating to care provision and the management of the service were accurately maintained and securely stored. The provider had sought to improve the service against nationally recognised guidance and practice standards concerned with people’s care. Service improvement planning and management monitoring arrangements, helped to ensure ongoing and continuous service improvement.

Further information is in the detailed findings below.

Inspection areas

Safe

Good

Updated 16 October 2018

The service was Safe.

People received safe, accurately informed care and support. Staff supported people safely to take their medicines when required. People’s care was provided by staff who were safely recruited and deployed. Revised staffing and related management strategies helped to ensure this. The provider’s nationally recognised safeguarding, infection prevention and control measures were understood and followed by staff when required.

Potential risks to people’s safety from their health condition or the unsafe use of any care equipment were effectively assessed and accounted for. Staff followed people’s care plans to help reduce any related risks identified to people’s safety and to report any health-related incidents when required. This helped to protect people from the risk of harm or abuse.

Effective

Good

Updated 16 October 2018

The service was Effective.

Revised care planning and staff supervision measures helped to ensure people’s needs and choices were effectively accounted for. Staff were trained, informed and supported to provide people’s care in the least restrictive way, which they followed.

Staff supported people to maintain and improve their health when required. Staff understood people’s health conditions, any dietary requirements and followed people’s related personal care plans. This was done in consultation with external health professionals when required.

Caring

Good

Updated 16 October 2018

The service was Caring.

Staff were kind, caring and ensured people’s dignity, choice, independence and rights when they provided care. Measures were introduced to ensure the consistent provision of accessible care and service information for people or their representative. People or their chosen representative, were informed and involved to agree people’s care, in a way they understood. People were supported to access relevant advocacy services if they needed someone to speak up on their behalf.

Responsive

Good

Updated 16 October 2018

The service was Responsive.

Service improvements were evident to ensure people received timely, individualised care. Revised management measures informed and supported people or their representatives if they needed to make a complaint about the service. The provider regularly sought people’s views and had taken account of any comments, concerns and complaints received; to help inform care and service improvements

Staff knew how to communicate with people in the way they understood and followed people’s views and wishes for their care. This was done in a way which helped to promote people’s inclusion and independence.

People received informed personal care, to help ensure they experienced a personalised, comfortable and dignified death in their own home when required, as they chose.

Well-led

Good

Updated 16 October 2018

The service was Well-Led.

Revised management, record keeping, communication and staffing measures had improved the safety and effectiveness of people’s care. People, relatives and relevant external care professionals were confident of this. Service improvement planning and management monitoring arrangements for people’s care and safety, helped to ensure ongoing and continuous service improvement.

Staff understood and followed their responsibilities for people’s care. Partnership working with relevant external health and social care professionals helped to inform and improve people’s care experience. The provider demonstrated where they had reviewed their service against relevant national guidance to further ensure this.