Archived: Better Healthcare Services (Brighton)

Updated 17 February 2017

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.

The inspection took place on 10 January 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.

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 provider was not requested to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

Before the inspection we checked the information that we held about the service and the service provider. We considered information which had been shared with us by the local authority and looked at notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law. We used all this information to decide which areas to focus on during our inspection.

During our inspection we spoke with 10 people who use the service, seven relatives and three healthcare professionals on the telephone, five care staff, a care co-ordinator, the care manager and the registered manager. We observed the provider and staff working in the office dealing with issues and speaking with people who used the service over the telephone.

We reviewed a range of records about people’s care and how the service was managed. These included the care records for five people, medicine administration record (MAR) sheets, four staff training, support and employment records, quality assurance audits, incident reports and records relating to the management of the service.

Updated 17 February 2017

The inspection took place on the 10 January 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.

Better Healthcare Services (Brighton) is a domiciliary care service which provides personal care and support services for a range of people living in their own homes. At the time of our inspection approximately 77 people were receiving a service.

The service had a registered manager. 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.

At the last inspection in November 2015 we identified areas of practice that needed to improve these included, medication administration records (MAR) had not always been completed accurately, procedures in relation to disclosure and barring (DBS) checks had not always been followed, concerns were raised in relation to communication between staff, records of spot checks had not routinely been completed, results and analysis of feedback questionnaires had not taken place and staff meetings were held irregularly. At this inspection on 10 January 2017 we found that improvements had been made and the overall rating for this service has been revised to good.

The experiences of people were positive. People told us they felt safe, that staff were kind and the care they received was good. One person told us, “They are absolutely excellent. They are brilliant and I feel very safe with them”. A relative added, “They are just marvellous. I know [my relative] is in safe hands with these people”.

The service was very flexible and responsive to people’s individual needs and preferences. Staff found innovative and creative ways to enable people to have an enhanced sense of wellbeing and exceptional quality of life. People told us that staff had outstanding skills, and had an excellent understanding of their needs. Healthcare professionals told us that the service was focused on providing person centred care and that it achieved exceptional results. One healthcare professional told us, “They have given [person] a level of care and quality of life that is exceptional. They have allowed them to access a normal life”.

People told us that staff were friendly and caring. One relative told us, “They are really brilliant. My relative really looks forward to them [the care workers] coming, because he has such a good rapport with them”. People were happy with the care they received, and said they saw regular consistent staff that knew them well and treated them with kindness. One person told us, “I’m very happy, it’s usually the same group of people who come all the time and they’re so cheerful that I look forward to seeing them”.

The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it. People were supported to maintain good health and had assistance to access to health care services when needed.

Risks to people were assessed and monitored to ensure action was taken to avoid accidents and the deterioration of people’s health. The service had recruited a sufficient number of suitably qualified staff to meet people’s needs. Recruitment practice was robust and protected people from the risk of receiving support from staff who were unsuitable.

The service considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded.

Staff were skilled and felt fully supported by the provider to undertake their roles. They were given training updates, supervision and development opportunities. One member of staff told us “The induction I had gave me the experience and the training gave me the knowledge”.

People and their relatives were given information on how to make a complaint. Feedback from people was asked for and responded to. One person told “I think there is something in there about how to complain, but to be honest, I’m not interested, because I have no complaints”.

The service was well led and had good leadership and direction from the provider. People, relatives and health professionals were complimentary of the management of the service. A relative said, “I certainly wouldn’t want another company, because overall they are excellent”. Staff felt fully supported by the provider to undertake their roles. There were quality assurance systems in place to ensure a high quality of care and support was provided.