Bionicare (Domiciliary Care Agency)

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People were being supported to live in ‘supported living’ settings however some aspects of RSRCRC and living in a supported living setting were not always being considered or followed. It was sometimes unclear how people’s needs had been assessed under best practice guidance or how staff supported people to achieve outcomes related to their support needs.

The staff team worked well together and with other professionals to help support people in the best way possible. Staff had a good understanding of the Mental Capacity Act (MCA) and supported people in line with the principles of this.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Although people’s assessments were detailed when they started using the service, some aspects of RSRCRC and supporting people in a supported living setting were not considered when people started using the service. For example, when new people started using the service this was not always discussed with people already living at the service. The provider was involved in the supported living business and also the business which owned the buildings where people were being supported. This was a potential conflict of interest if people wanted to change their care provider. This had also not been discussed with people. Whilst people’s needs were assessed when they started using the service, when changes happened to their support, care plans were not always reassessed and updated in a timely manner. For example, 1 person needed support to follow a specific diet and there was limited information assessed and added to their care plan in relation to this. The registered manager and provider took the findings from this assessment seriously and started implementing improvements such as updating care plans and updating policies in relation to how to support people in line with RSRCRC.

People told us they had good experiences when they started using the service. One person said, ‘‘All the managers and staff team came and met me when I first moved in. They threw me a party and made it all feel really special. I came and visited the service a few times before I moved in so I knew I would like it.’’ Staff told us they were supported to get to know people before they started using the service and spend time getting to know them when they started using the service.

People were not always being supported in line with best practice and evidence-based treatment. For example, some aspects of supported living and RSRCRC were not being considered. The provider told us people could use their service to learn the skills they needed to then move on to live independently. However, it was not clear how people were being supported with this or if this is something people wanted to do. People’s support hours were not being monitored to make sure they were being supported with all their support needs. The audits being completed by the management team did not focus on aspects of people’s support such as whether they were being supported in line with RSRCRC, and this was not discussed with staff regularly in meetings or supervisions. The registered manager took the findings from this assessment seriously and started making improvements. This included updating staff competency checks to include RSRCRC and implementing more effective audits to monitor people’s support hours.

People were very positive about how they were supported. Their comments included, ‘‘The staff work hard to make sure we have the best experiences we can have. They are always there for you.’’ and ‘‘The management and staff team always want what is best for us. I know the staff have had lots of training.’’ Staff had training and a good understanding of how to support people with their needs and understood RSRCRC. The provider and registered manager were keen to continually update themselves on best practice and told us how they would start to do this.

The staff team worked well together and enjoyed their job roles. They told us how they contacted other services such as health professionals if people needed support. They recorded health professionals’ advice and discussed this to ensure it was followed in staff meetings. One person said, ‘‘The staff all get on well together like one big family. There is a lot of banter, and this makes the atmosphere really nice.’’ A professional working with the service said, ‘‘[People] are really happy using the service and we have a good working relationship.’’

Staff had the training they needed to support people and were knowledgeable about this. They had regular meetings and discussions with the management team to help ensure their training had been effective and to discuss any more training they felt would help them support people.

It was not always clear how people were being supported to lead healthy lives. For example, one person was following a specific diet. However, staff did not record how this was being supported in their daily records. This made it more difficult to see how people were being supported to live healthily in line with their support needs. Where people’s needs changed, their care plans were not always clearly updated to show staff how to support them to be healthy in line with these changes. Living healthily was not being discussed with people to see if there was something they wanted more support with in relation to their health. Daily records were being monitored however audits did not make it clear how people’s support needs in relation to their health were being audited and checked to ensure they had the right support.

People told us staff supported them to be healthy in ways such as speaking about how things were going regularly and taking regular exercise. One person said, ‘‘I like to eat certain things, but the staff always talk to me about healthier choices. They never force it on me, but they always have the talk with me. I sometimes choose to have other things because of this.’’ Another person said, ‘‘Staff come with me for exercise sometimes to make sure I stay fit and feel well.’’ Staff told us they supported people to stay healthy as far as possible whilst respecting their choices.

It was not always clear how people were supported to monitor and improve outcomes in relation to their health and wellbeing. People had some goals and ambitions in relation to their health recorded in their care plans. However, staff were not always recording how they were supporting people in line with these in daily care records. People’s goals in relation to their health were not being reviewed regularly to see if people still wanted to achieve these goals or how staff were progressing by supporting them with these. It was unclear from people’s records and care plans what outcomes they had achieved since they started living at the service. The provider and registered manager told us they did not always monitor this as they collected feedback on how things were going from people on an almost daily basis and people were happy with the service. However, they said they would review how people’s outcomes were being monitored and improved.

People were happy living at the service and told us staff supported them to work towards their outcomes. One person said, ‘‘Before I started living here, I was in a very bad place and causing myself a lot of problems. Thanks to the staff team I am much better now, and this is due to the help they gave me. I truly think they have saved my life.’’ Another person told us, ‘‘I have wanted to do things for myself for a long time and am finally being supported to do this. I cannot be more thankful for the support I have here.’’

People were supported in line with the MCA. Staff had a good understanding of this and how to support people in line with its principles. The registered manager and provider had processes in place to support people where they may not have capacity to make decisions. This included completing assessments and putting decisions in place in people’s best interests. One person said, ‘‘I am in full control of every aspect of how I live, and staff respect every decision I make. They treat me with a lot of dignity.’’