Archived: Brookleigh Caring Services

Updated 9 September 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.

This inspection took place on 4 and 15 May and 8 June 2017 and was announced. 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.

The inspection team consisted of two adult social care inspectors and one pharmacy inspector. Three experts by experience telephoned people in their own homes to gain their views of the service. These calls took place between 4 and 5 May 2017. An expert-by-experience is a person who has personal experience of using or caring for someone who uses a service, on this occasion a domiciliary care service.

Before the inspection we reviewed all of the information we held about the service, such as notifications we had received from the service and also information received from the local authority who commissioned the service. Notifications are details of changes, events or incidents that the provider is legally obliged to send us within a specified timescale.

The provider completed a provider information return (PIR) and returned this to us on 5 February 2017. 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.

During our inspection we spoke with one of the directors of Brookleigh Caring Services Ltd, the registered manager, a care co-ordinator, three care workers and one senior care worker. During and after the inspection visit we spoke on the phone with 32 people who used the service and 11 relatives of people that used the service. We emailed the registered manager a set of questions to be handed to all 70 care staff and we received 11 responses.

We reviewed the care records of six people that used the service, reviewed the records for six staff and also records relating to the management of the service. We also looked at the medicine records of nine people who used the service and visited five people in their own home to make sure that appropriate arrangements were in place to manage medicines safely.

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 respected people’s privacy and dignity.

People were supported to maintain good health and to access health professionals when needed.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken prior to staff starting work.

Staff had been receiving regular supervision and annual appraisals to monitor their performance.

Staff had received training on the Mental Capacity Act (2005) and demonstrated an understanding of the requirements of the Act.

We saw that people were given support to ensure their nutritional needs were met.

Staff meetings were held regularly and staff who were unable to attend had access to the meeting minutes. The registered manager was described as approachable and staff told us they felt supported by management.

We identified a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered provider to take at the back of the full version of the report. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.