Blay Domiciliary Services

Updated 14 February 2024

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 undertaken by 1 inspector and 1 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 homes.

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 2 working days' notice of the inspection. This was because we needed to be sure that a member of the management team would be in the office to support the inspection. Inspection activity started on 11 December 2023 and ended on 15 December 2023. We visited the office location on 11 December 2023 and 13 December 2023.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). 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 asked for feedback from the local authority and reviewed notifications from the provider. A notification is information about important events, which the provider is required to send us by law. We asked for feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

During the inspection

We looked at 12 people's care records to check that the care they received matched the information in their records. We reviewed 4 staff files to see how staff were recruited. We looked at the systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement. We spoke with 5 people using the service and 5 relatives to get their views of the service. We also received feedback from 20 staff that worked at the service. We also spoke with the registered manager.

Updated 14 February 2024

At the time of the inspection, the location did not offer care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service

Blay Domiciliary Services is a domiciliary care service. It provides care for people living in their own homes. CQC regulates the personal care and support. There were 262 people who received personal care at the time

of the inspection.

People's experience of using this service and what we found

Health and safety concerns were not always included in people's care and treatment plans. The risks were not always mitigated effectively because the guidance for staff did not follow good practice guidance or adapted control measures to make sure the risk was as low as is possible.

Staff did not ensure that people's medicines were available in the necessary quantities at all times to prevent the risks associated with medicines that are not administered as prescribed. Administration of people medication was not always recorded accurately.

When people lacked mental capacity to make informed decisions, or give consent, staff did not always act in accordance with the requirements of the Mental Capacity Act 2005 and associated code of practice. As a result, people were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The provider did not have fully effective systems and processes such as regular audits of the service to assess, monitor and improve the quality and safety of the service. Information about people were not always up to date, accurate and properly analysed or reviewed. Provider's processes to minimise the likelihood of risks and impact of risks on people who use service were not fully effective.

Staff received training on how to protect people from abuse and knew the procedure to follow to report concerns. People and their family members were mostly happy with the care, however some told us that staff would benefit from further training and coaching. The provider was already aware of this and was actively seeking way to improve staff skills and provide opportunities to develop.

People received support from staff that had undergone recruitment checks. Staff worked within the providers' policy and procedure for infection prevention and control.

Staff worked collaboratively with other partner agencies and health professionals to support people with achieving good outcomes.

Staff enjoyed their job and felt supported by the management. The management were aware of any concerns shared by people and worked on finding way to resolve issues and concerns.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 18 July 2022).

Why we inspected

The inspection was prompted in part due to concerns received about risk management and medicines. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We inspected and found there was a concern with assessing people's mental capacity, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, effective and well-led.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

Enforcement

We have identified breaches in relation to safe care and treatment, mental capacity assessments and governance at this inspection.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.