You are here

Boldglen Limited Medway Swale Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 23 February 2021

About the service

Boldglen Limited Medway and Swale is a domiciliary care service providing personal care to people living in their own homes. The service also provided personal care to people living in flats within an extra care housing scheme in the borough of Swale. Not everyone who used the service received personal care. The Care Quality Commission (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. The service was providing personal care to approximately 177 people at the time of the inspection.

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

There continued to be shortfalls in the service provided to people.

Individual risks were not always assessed and managed to keep people safe. People could not be sure their prescribed medicines were always managed in a safe way. When people had accidents and incidents, appropriate reports had not been completed which meant action had not been taken to review and reassess people’s care needs and medical professionals had not been informed.

People could not be assured new staff were adequately checked to ensure they were suitable to work with people to keep them safe. We found no evidence that people had been harmed however, systems were either not robust enough to demonstrate staff recruitment was effectively managed. Staff had not always been allocated travel time to enable them to travel between care calls, this meant people received late care calls and staff were rushed to get to their next care call. One person told us, their staff member frequently finished their care call early.

Although initial assessments were undertaken with people before they received a service, the information gathered was not always used to develop a care plan where needed. Care plans were in place. However, care plans were inconsistent and did not always detail the relevant information staff would need to meet people's assessed care and health needs.

Records were not always accurate, complete or contemporaneous. Although there had been audits and checks of the service completed, these were not robust. This meant the management team were not always aware of concerns, changes in health or medicines issues, which led to delays in action being taken where needed.

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.

Staff had received training to make sure they had the skills to meet people's specific care needs. Staff told us they felt well supported by the management team.

Most people and relatives gave us positive feedback about their care and support. They told us, “They are all wonderful and see to my needs well”; “I have a regular male carer, who has become more of a friend. Knows me well”; “I am very happy with my carers”; “They are excellent” and “They phone me and ask how things are by way of feedback and I told them I am very happy with them.” One relative and one person raised some concerns in their feedback which we reported to the registered manager so that the management team could address these.

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

Rating at last inspection and update

The rating at the last inspection was requires improvement (published 23 October 2019) and there were breaches of regulation 9,11,12,17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The provider completed an action plan after the last inspection to show what they would do and when they would improve by. We met with the registered manager on 31 October 2019 to discuss the repeated rating of requires improvement and set out expectations as well as listened to their planned improvements.

At this inspection we found the provider had made some improvements by ensuring that staff received training and support to carry out their roles safely and consent and capacity had been improved. However, the provider requires further improvement in medicines management, risk assessment, safe recruitment practice, effective staff deployment, effective assessment and care planning and effective quality monitoring.

Why we inspected

CQC have introduced targeted inspections to follow up on requirement actions, warning notices or to check specific concerns. They do not look at the entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of the key question.

We undertook this targeted inspection to check whether the Warning Notices and Requirement actions we previously served in relation to Regulation 9, 11, 12, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Boldglen Limited Medway Swale on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We identified a new breach of Regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to effective deployment of staff. Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection areas

Safe

Inadequate

Updated 23 February 2021

At our last inspection we rated this key question Inadequate. We have not reviewed the rating at this inspection. This is because we only looked at the parts of this key question we had specific concerns about.

Effective

Requires improvement

Updated 23 February 2021

At our last inspection we rated this key question Requires Improvement. We have not reviewed the rating at this inspection. This is because we only looked at the parts of this key question we had specific concerns about.

Caring

Good

Updated 23 February 2021

Responsive

Requires improvement

Updated 23 February 2021

At our last inspection we rated this key question Requires Improvement. We have not reviewed the rating at this inspection. This is because we only looked at the parts of this key question we had specific concerns about.

Well-led

Requires improvement

Updated 23 February 2021

At our last inspection we rated this key question Requires Improvement. We have not reviewed the rating at this inspection. This is because we only looked at the parts of this key question we had specific concerns about.