Balkerne Gardens Trust Care at Home

Balkerne Gardens Trust is a domiciliary care service providing personal care to people in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection the service was supporting 52 people with 32 of these people receiving support with personal care.

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

People received an exceptionally caring service. Every person we spoke with throughout the inspection praised the quality of care. People told us they felt supported and truly valued as individuals and believed staff genuinely cared. We heard words such as 'excellent', 'wonderful', 'genuinely caring' and 'first class’ being used to describe the service and staff.

People's care was exceptionally responsive. Care plans were personalised and had been developed with people. Care and support provided was flexible and quickly adapted to meet people’s changing needs.

People were supported by small and consistent staff teams who knew people extremely well and trusting relationships had been formed. We saw numerous examples where the staff had gone above and beyond to ensure people's physical, emotional, leisure and cultural needs were met. We were consistently told that staff were sensitive and respectful when visiting people in their own homes and when providing personal care.

Balkerne Gardens Trust was exceptional at placing people at the heart of the service. The managers and staff had a strong focus on people having as many opportunities as possible to maintain their independence and reduce the risk of social isolation.

There was a very positive, enabling culture in the service. Staff attributed this to the standard of training, support and outstanding leadership. The service was exceptionally well led, and staff felt well supported by a caring management culture with a clear focus on continuous improvement.

People's voices were of paramount importance. Staff shared the same hopes and aspirations

for people to continue to live the lifestyle of their choice. People highly praised the quality of the service they received and the positive impact it had on them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The provider worked with other professionals and organisations to provide advocacy support and share training to ensure positive outcomes for people. The provider was involved in a number of initiatives to improve people's wellbeing. These included providing advice and support to enable people to stay safe from the risk of scams and health promotion.

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 10 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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.

The registered manager provided exceptionally strong, clear leadership and ensured an enabling and person centred culture was firmly embedded in the service. People, relatives, stakeholders and staff spoke very highly of the leadership of the service, and held the registered manager and provider in high regard. In the two years since the service has been established, there was a clear commitment to putting people at the heart of the service. People using and working for the service were empowered to provide their feedback of the service provided and this was used to promote continuous improvement. The service was committed to ‘putting the person first,’ and working in partnership with them, this approach underpinned everything they did.

People told us they felt safe and trusted the care workers who came into their home. They were protected from the risk of harm, as management and care workers had undertaken training to recognise, respond and report safeguarding concerns. They felt confident to speak up if they had concerns which ensured referrals were made promptly to the appropriate professionals. Risks associated with care workers providing, and people receiving care and support in their own homes, were also well managed. This demonstrated effective oversight of potential or actual risks to people using and providing the service.

People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There were sufficient numbers of care workers to provide safe care. People were complimentary about care worker’s timekeeping and the quality of the caring and friendly care workers. People were cared for by care workers who were safely recruited, inducted, supported, supervised, and appraised. Care workers received training in core skills to support them providing a safe service. The registered manager and management team kept up to date with models of positive care and shared the information with the rest of the team to promote good quality care. They observed care workers in their duties to identify areas of good practice and areas for development. The vision of the service was shared by the motivated staff team and put into practice.

People received care and support which was responsive to their physical and mental health needs, rights, wishes and preferences. People, or their representatives, where appropriate, participated in the planning of their care. Care plans provided detailed information about the person and how they wanted to be supported. This ensured that people were supported as individuals and encouraged to maintain their independence in ways that were important to them. Where required, people were given the level of support they needed to ensure they took their medicines as prescribed and supported to have enough to eat and drink. Where care workers had identified concerns in people’s wellbeing appropriate prompt action was taken to contact other health and social care professionals to support people’s wellbeing.

There was a deep level of understanding of the impact of having robust and effective quality assurance systems which led to service improvements and continual development. The registered manager had good oversight of the service and was committed to gaining feedback from people, whether positive or negative. They were innovative in the ways they did this including arranging social events at the location’s office, where people mixed with others using the service, enabling them to share their experiences.

There was an open and empowering ethos in the service. Management were innovative and dynamic, continually seeking to improve what the service offered people. The leadership was clear about their expectations relating to how the service should be provided. A vision shared by the staff who felt valued, recommended the provider as an employer who took an active interest in their safety and welfare, and supportive of being able to provide a quality service.