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Archived: Brookleigh Caring Services Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 9 September 2017

The inspection took place on 4 and 15 May and 8 June 2017. The inspection was announced. This means the registered manager was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that staff would be available to support the inspection.

Brookleigh Caring Services is a domiciliary care agency registered to provide personal care to people in their own home. At the time of our visit there were 309 people receiving personal care calls.

The service had a registered manager in place. 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.

The service was previously inspected on 19 January 2016 and was not meeting one of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to safe care and treatment. We took action by requiring the registered provider to send us action plans telling us how they would improve this. When we returned for this inspection we found the issues identified had not been addressed.

The systems and processes in place to protect people from the risk of harm were still not sufficiently robust. We saw that some risks had been identified without any information on how staff could mitigate these risks. Other risks were apparent from information in people’s care records but no risk assessment was in place.

We considered that the service was failing to protect people using the service against the risks associated with the unsafe use and management of medicines.

Clear and accurate records were not being kept of medicines administered by care workers. Gaps in the medicines administration records meant we could not be sure people were always given their prescribed medicines. Details of the strengths and dosages of some medicines were not recorded correctly. Care plans and risk assessments did not support the safe handling of people’s medicines.

Complaints were not always being handled in line with the registered provider’s complaints policy.

Records were not always comprehensive or up to date. Contact information we were given was not current. Some people’s care plans lacked the level of detail required to be person centred. Person centred planning is a way of helping someone to plan their life and support, focusing on what’s important to the person.

A number of people we spoke with told us it was difficult to contact the office and calls were not always returned. People did not always receive rotas informing them which staff would be providing their care.

Although there were systems in place to monitor and improve the quality of the service provided these were not being used effectively to make improvements. The results of a satisfaction survey was analysed but no action plan was produced and people’s comments were not taken into consideration. Audits of care plans and medicines had not picked up the issues we identified.

Staff were able to tell us about different types of abuse and were aware of the action they should take if they suspected abuse was taking place. Staff were aware of whistle blowing procedures and all said they felt confident to report any concerns.

Appropriate environmental checks had been done on people’s homes to ensure health and safety of staff and the people they cared for.

Staff had received appropriate training and had the skills and knowledge to provide support to the people they cared for. New staff had a comprehensive induction and shadowed a more experienced colleague until they were sufficiently confident and capable to work alone.

People who used the service were happy with the care provided by staff. Staff were knowledgeable about the people they provided care to; they promoted independence and respecte

Inspection areas

Safe

Requires improvement

Updated 9 September 2017

The service was not always safe.

Individual risk assessments were not always in place and those that were did not always include sufficient detail on how to mitigate risk.

Medicines were administered safely but we saw that medicine records were not always correct.

Staff had received safeguarding training and had knowledge of how to look for signs of abuse and report concerns accordingly.

Effective

Good

Updated 9 September 2017

The service was effective.

People were cared for by staff who had the right skills and knowledge to care for them. Staff had received the appropriate training.

Staff had received training on the Mental Capacity Act (2005) and demonstrated an understanding of how to apply this in practice.

People were supported to access healthcare and their nutritional and hydration needs were met.

Caring

Good

Updated 9 September 2017

The service was caring.

People were happy with the level of support they received and felt staff were kind and caring.

Staff knew how to treat people with respect and dignity.

People were encouraged to be independent where possible and given the right level of support when they needed it.

Responsive

Requires improvement

Updated 9 September 2017

The service was not always responsive.

Complaints were not always being handled in line with the registered provider�s policy. Some complaints had not been correctly followed up.

People had care plans in place that addressed their support needs but these could be improved with the inclusion of more detail.

People were involved in decisions about their care and how they wished to be supported.

Well-led

Requires improvement

Updated 9 September 2017

The service was not always well led.

Records were not always accurate or up to date and people told us they had difficulty contacting the office.

The registered manager carried out regular quality assurance checks but audits were not picking up issues we found. Survey data was not used to improve the service delivery.

Staff meetings were held regularly and staff spoke positively about the support they received from management.