Blue Ribbon Community Care in South West London

Blue Ribbon Community Care in South West London is a domiciliary care agency. It provides personal care and support to people living in their own homes. At the time of our inspection 22 people were receiving personal care from them. Most people were older adults who had a range of physical disabilities and were also living with dementia.

20 other people who also received domiciliary support from this agency but did not receive a regulated activity from them. This included companionship and cleaning services. The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; 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

People’s experiences of using this service had improved in the 12 months since their last inspection. The overall rating for this service has therefore increased from ‘Requires improvement’ to ‘Good’.

This was because we found at this inspection the provider had followed the action plan they had sent us and taken appropriate steps to improve people’s care plans and risk management plans to make them more person centred, staffs medicines record keeping, training for staff and the way they operated their quality monitoring systems.

People using the service and their relatives told us they were happy with the service provided by this agency. This quote we received from a relative sums up how people typically felt about this domiciliary care agency, “We’re all very happy with the home care service we’ve received from Blue Ribbon and would happily recommend them to family and friends…The staff are all very kind and caring.”

The improvements described above notwithstanding we have made a recommendation about the way the provider manages informal concerns they receive about their service.

The service had safeguarding procedures in place and staff had a clear understanding of these procedures. Appropriate staff recruitment checks took place before new staff started working for the service. Staff scheduled visits were well-coordinated., which meant they were punctual. The service had procedures in place to reduce the risk of the spread of infection.

Staff had the right mix of knowledge, skills and experience required to meet people’s needs. Staff routinely sought the consent of the people they supported ensuring they had maximum choice and control of over their lives. Where staff were responsible for this, people were supported to maintain a nutritionally well-balanced diet. People received the support they needed to stay healthy and to access community-based health care support as and when required.

People received support from staff who were kind and compassionate. Staff treated people with dignity and respected their privacy. Staff met people’s spiritual and cultural needs and wishes. People were encouraged and supported to develop their independent living skills. Assessments of people’s support needs were carried out before they started using the service.

People’s care plans were developed from these assessments and routinely reviewed to ensure they remained up to date. People had been consulted about their support needs and involved in helping staff develop their personalised care plans. People’s end of life care wishes were recorded in their care plan.

Management support was available for staff when they needed it. The provider promoted an open and inclusive culture which sought the views of people using the service, their relatives, professional representatives and staff. The provider worked in close partnership with other health and social care professionals and agencies to plan and deliver people’s packages of care and support.

Rating at the last inspection

At the last inspection the service was rated ‘Requires Improvement’ overall (Report was published on 12 June 2018) and for four out of the five key questions including, ‘Is the service safe, effective, responsive and well-led?’ Following that inspection, we asked the provider to complete an action plan to show us what they would do and by when to improve these key questions, to at least ‘Good’.

Why we inspected

This inspection was carried out as part of our scheduled plan of visiting services rated requires improvement within 12 months of their last inspection report being published. This inspection was carried out to check the quality and safety of the service people received and that provider had done what they said they would in the improvement plan we asked them to complete.

Follow up

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates in keeping with our inspection methodology (See above).

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

This inspection was carried out on 18 and 23 April 2018 and was announced. We gave the provider 48 hours’ notice of the inspection because we needed to be sure that someone would be in when we come to inspect the service.

At the last inspection on 11 December 2015 the service was rated GOOD. At this inspection we rated the service Requires Improvement, with Requires Improvement in the key questions safe, effective, responsive and well-led.

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.

We identified breaches of regulation during the inspection. You can see the action we have told the provider to take with regard to the breaches at the back of the full version of this report.

Risk assessments had not always addressed the support people required to minimise risks. Information was missing on the assistance people needed to meet their individual needs safely.

Staff had not completed appropriate training to gain the required knowledge and skills to support people effectively.

There were no quality assurance processes in place to monitor improvements required to ensure people’s safety. Although people were supported in relation to their medicines, we found that medicine administration sheets were not completed correctly.

Care records were not always fully completed and information about people’s health conditions was missing. We have made a recommendation about this.

Staff worked in conjunction with relatives and healthcare professionals to assist people to take their medicines as prescribed. However, people's medicines were not signed for appropriately by the staff team. We have made a recommendation about this.

People told us that staff stayed for the full duration of their shifts as required. However, they had not arrived on time to support them as necessary.

People told us they were well cared for by the Blue Ribbon Community Care in South West London which made them feel safe. Systems were in place to monitor any safeguarding investigations reported and actions were taken to protect people as necessary. Pre-employment checks were undertaken to ensure staff’s suitability for the role. Systems were in place and people had information on how to complain if necessary.

Staff approached the management team for support and advice at any time they required it. Staff had information and followed the service’s processes to get to know people before they started supporting them. People had assistance to do on-line food shopping which gave them more options of what food they wanted to buy. Staff were in-contact with healthcare professionals where people needed support to meet their health needs. Processes were in place to support people to make their own decisions where possible as required by the Mental Capacity Act (MCA) 2005.

Staff were patient and attended to people with care. People had their individual needs respected and staff helped them to make choices as necessary. Staff encouraged people to engage and undertake activities for themselves which increased their independence.

Staff responded to people’s care needs based on their preferences and how they wanted to be supported on the day. People and their relatives were involved in developing the care plans and had to consent to them before they were finalised. People were encouraged to share their opinions and to provide feedback about the support they received. Staff worked in conjunction with healthcare professionals to support people at the end of their lives.

The management team was approachable and supportive when people and their relatives contacted them. There were good communication systems in place that enabled staff to share information efficiently. The management team worked together and shared responsibilities to monitor the staff team.