You are here

Reports


Inspection carried out on 13 August 2020

During an inspection looking at part of the service

About the service

Bridges Homecare is a domiciliary care agency (DCA). The service provides personal care services to people

in their own homes or people in supported living arrangements.

At the time of our inspection 135 people received personal care as the regulated activity. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

The last rating for this service was Requires Improvement (Report published 1 February 2020). At the last inspection we found medicines management was not based on current best practice.

The systems in place to monitor the quality of service were not always effective in that they had not identified the concerns found in relation to their registration and medicines management. This was a breach of Regulation 17 HSCA RA Regulations 2014 Good governance.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider had taken action and improvements had been made. The provider was no longer in breach of this regulation.

People's experience of using this service

Medicines were administered and managed safely. Records were accurate and up to date and staff’s competency to safely administer medicine was regularly checked and recorded.

The registered manager had quality assurance systems in place to monitor the quality and safety of the service. This included monitoring of medicine management systems. The service had a clear management and staffing structure in place and promoted a positive, caring culture.

People told us they felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns. People had risk assessments in place to enable them to be as independent as they could be in a safe manner.

There were sufficient staff on duty to support people with their needs and keep them safe. Effective and safe recruitment processes were consistently followed by the provider.

People were safe from the risk of infection. This included measures introduced by the provider to safeguard people and staff from COVID-19.

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bridges Home Care Ltd on our website at www.cqc.org.uk.

Inspection carried out on 11 October 2019

During a routine inspection

About the service

Bridges Homecare is a domiciliary care agency (DCA). The service provides personal care services to people in their own homes or people in supported living arrangements.

At the time of our inspection 98 people received personal care as the regulated activity. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

It is a requirement of the Health and Social Care Act 2008 that providers register locations appropriately. We visited Bridges Homecare on 24 September 2019 and found that the service was not operating from their registered address. Although the provider took action to correct this they had failed to ensure they had carried out the conditions of their registration.

The medicines management was not based on current best practice. The systems in place to monitor the quality of service were not always effective in that they had not identified the concerns found in relation to their registration and medicines management.

People and their relatives were positive about the service and the care provided.

People were cared for by staff who knew how to keep them safe and protect them from avoidable harm.

People were encouraged to maintain a good diet and to access health services when required. People were supported to avoid social isolation. Incidents and accidents were investigated, and actions were taken to prevent recurrence

Enough staff were available to meet people's needs. People told us staff followed infection control and prevention procedures.

Care was delivered by staff who were well trained and knowledgeable about people's care and support needs. People's needs were assessed, and care was planned and delivered to meet legislation and good practice guidance.

People's dignity, confidentiality and privacy were respected, and their independence was promoted.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

Bridges Homes Care is not a new service, the provider had changed location, therefore this was their first inspection. The previous location was rated Good in March 2017.

Why we inspected

This was a planned, routine inspection.

Follow up

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

Inspection carried out on 2 March 2017

During a routine inspection

We carried out an announced inspection of Oxford House on 2 March 2017.

Oxford House is a domiciliary care agency providing care and support to more than 100 people living in their own homes. On the day of our inspection 169 people were receiving a personal care service.

At our last inspection on 3 February 2016 we found medicines were not always managed safely, medicine records were not always complete. This was a breach of Regulation 12 Health and Social Care Act (Regulated Activities) Regulations 2014. We also found the provider did not have effective systems in place to ensure the quality of the service was monitored and improved to ensure the regulations were met. This was a breach of Regulation 17 Health and Social Care Act (Regulated Activities) Regulations 2014.

In addition we recommended the service took action to ensure people's care records identified how they would be supported in line with the principles of the Mental Capacity Act 2005.

At this inspection on 2 March 2017 we found the provider had made improvements and had addressed these concerns.

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.

We were greeted warmly by staff at the service who seemed genuinely pleased to see us. The atmosphere in the office was open and friendly.

People told us they were safe. Staff understood their responsibilities in relation to safeguarding. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.

People were supported by staff who were knowledgeable about people’s needs and provided support with compassion and kindness. People received high quality care that was personalised and met their needs.

Where risks to people had been identified, risk assessments were in place and action had been taken to manage these risks. Staff were aware of people’s needs and followed guidance to keep them safe. People received their medicines as prescribed.

There were sufficient staff to meet people’s needs. Staffing levels and visit schedules were consistently maintained. People told us staff were usually punctual and they had not experienced any missed visits. The provider followed safe recruitment procedures and conducted background checks to ensure staff were suitable for their role.

Most staff understood the Mental Capacity Act 2005 (MCA) and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves. The registered manager was knowledgeable about the MCA and how to ensure the rights of people who lacked capacity were protected.

People told us they were confident they would be listened to and action would be taken if they raised a concern. The service sought people’s opinions through regular surveys and telephone monitoring calls. The service had systems to assess the quality of the service provided. Learning needs were identified and action taken to make improvements which promoted people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

Staff spoke positively about the support they received from the registered manager and senior staff. Staff supervision and meetings were scheduled as were annual appraisals. Staff told us the registered manager was approachable and there was a good level of communication within the service.

People told us the service was friendly, responsive and well managed. People knew the registered manager and staff and spoke positively about them. The service

Inspection carried out on 3 February 2016

During a routine inspection

We carried out this inspection on 3 February 2016. This was an unannounced inspection.

Oxford House provides domiciliary care services to people who live in their own home. The service provides support to people with a variety of conditions including people living with dementia. At the time of our inspection there were 139 people using the service.

The service had 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.

Medicines were not always managed safely and medicine records were not always completed accurately. Systems for auditing the quality of the service had not identified these issues.

People's care records did not identify how they would be supported in line with the principles of the Mental Capacity Act 2005. We have made a recommendation in relation to the Mental Capacity Act.

The service promoted a caring culture, led by the registered manager. The service constantly looked for ways to improve and had recently implemented a new management structure. Staff were positive about the improvement in the support they received as a result of the change. People were complimentary about the management of the service and felt confident to raise any concerns.

People were supported by staff who had the skills and knowledge to meet their needs. Staff were kind and caring and knew how to treat people with dignity and respect. Staff had access to training and development opportunities and were well supported by the management team. People told us they felt safe and staff visited them when required to assist them with personal care.

Care plans were personalised and identified how any assessed risks would be managed. Where people required support with eating and drinking this was included in their care plans along with any specific dietary requirements.

We found one breach of the Health and Social Care Act 2008. You can see what action we told the provider to take at the back of the full version of the report.