Archived: Briarcare Recruitment Agency Ltd

There was a registered manager in post. 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 our last inspection of 3 and 8 November 2016 this service was rated as inadequate and placed in Special Measures by CQC. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Briarcare Recruitment Agency Ltd on our website at www.cqc.org.uk.

Improvements had been made in how the service provided safe care to the people who used the service. The service's medicines policy had been reviewed and updated. Systems were now in place to guide staff on the support that people required with their medicines. Systems had been improved in how staff had recorded when people had been assisted to take their medicines. Risk assessments were now in place which guided care workers on how the risks to people, relating to their specific conditions, falls and risks associated with people’s homes.

Improvements had been made in how the service notified us of incidents which they were required to do by law. The registered manager had updated themselves on notifiable incidents, and since our last inspection we had received notifications from the service as required.

Improvements had been made in how the service recorded care worker induction and shadow shifts. Training in the Mental Capacity Act 2015 had now been provided to care workers and care records included information about how people consented to their care.

People’s care records had improved and clear guidance was provided to care workers in how people’s individual needs and preferences were met. This related to the person centred care they required and preferred, including relating to their dietary requirements and independence. People told us that they were involved in the planning of their care.

Improvements had been made in how the service monitored and assessed the service provided. This included spot checks on care workers and asking for people’s views about the service they were provided with. The service had purchased a computerised system which assisted them in the monitoring of the service including, missed and late visits. This was not yet fully implemented and embedded in practice. However, the provider told us about the plans for the future to further improve.

There were systems in place which provided guidance for care workers on how to safeguard the people who used the service from the potential risk of abuse. Care workers understood their roles and responsibilities in keeping people safe.

Care workers were available to ensure that planned visits to people were completed. There were systems in place to recruit care workers safely. Care workers had good relationships with people who used the service.

Where required, people were provided support to access health care professionals.

There was a complaints procedure in place and people’s concerns were addressed in a timely manner.

There was a registered manager in post. The registered manager was also the provider. 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.

There were no formal quality assurance systems in place to continually monitor the service provided. This meant that the management team had missed opportunities to improve the service.

The management team were open and transparent throughout the inspection, seeking feedback to improve the service provided. However, at the time of the inspection, systems were not sufficiently robust to ensure that the registered provider was operating within expected standards of governance and ensuring effective oversight of the service.

Care plans were task focussed and extremely limited in detail. Important information about people was not recorded in their care records. People’s care plans did not always demonstrate that they had been involved in the planning of their care.

Care plans did not record the level of support each person required with their medicines. There were no protocols in place for medicines which were to be taken ‘when required’ to guide staff as to how and when these should be administered. There was no monitoring of people’s medicines and how staff recorded these.

Improvements were needed in how the service assessed and recorded risks in people’s daily living. Care records did not include detailed risk assessments to provide staff with guidance on how the risks to people were minimised.

Training provided was not effective in ensuring staff had the knowledge they needed to provide people with safe and effective care in line with their wishes and preferences. The competency of staff was not assessed through observational supervisions.

People told us that staff gave them the opportunity to make decisions for themselves. However management and staff had not received training relating to the Mental Capacity Act and were therefore unaware of the need to appropriately assess people’s capacity to make specific decisions.

There was some information included in people's care plans about their dietary needs but records lacked detail about their preferences. Where appropriate the service had made referrals to health care professionals such as the community nursing team and GP’s.

People told us they felt safe whilst receiving care in their homes. Systems were in place to reduce people being at risk of abuse. There were enough staff to deliver people's assessed care needs. People were protected by robust procedures for the recruitment of staff.

Staff demonstrated empathy, understanding and warmth in their interactions with people. People were confident in the ability of the staff and felt that they knew them well. People’s privacy and dignity was promoted and respected.

During this inspection 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 provider to take at the back of the full version of the report.

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to; Ensure that providers found to be providing inadequate care significantly improve. Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made. Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.