Bare Hall Quality Carers Limited

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection visit we found the service remained good.

Why the service is rated good.

People, relatives and staff all agreed the service was well managed. However, there was a common consensus that communication between staff in the office and staff providing direct care could be improved. We have made a recommendation about this.

Changes had been made to medicines processes to ensure they were in line with good practice guidance. However, these were not yet firmly embedded. We have made a recommendation about this.

Systems, processes and practices continued to be implemented to safeguard people from abuse and risk of harm. Good practice guidance had been followed to keep people safe. People and relatives told us safety was always considered.

Staff told us staffing rotas were planned in advance to allow them to visit the same people. They said this promoted consistency and allowed person centred care to be delivered.

People told us staff were reliable and always worked the allocated time. They said staff were empathetic and motivated to provide compassionate care.

People continued to receive personalised care which was responsive to individual need. Staff had a good understanding of people’s individual needs so care could be provided with support which was individual to them.

People received care which was regularly reviewed and support was based around good practice evidence. Staff were supported with continuous learning to ensure they had the correct skills to provide effective care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Consent to care and treatment was actively sought.

The organisation was currently reviewing technology to increase the effectiveness within the service.

The registered provider was responsive in seeking feedback from people and relatives to ensure people were happy with the service provided. We saw complaints were appropriately responded to.

Governance was embedded within the service and was based upon good practice guidance.

Further information is in the detailed findings below.

Bare Hall Quality Carers Limited is registered to provide personal care to people in their own homes. In addition the agency also provides other support to people such as shopping, household maintenance and other domestic services. The agency operates from a ground floor purpose built office and is accessible to anyone. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure someone would be in.

At the time of inspection, the registered provider employed 87 staff and delivered a service to 231 people across Morecambe, Lancaster and surrounding areas.

There was a registered manager in place. 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.

During this inspection carried out in June 2016, people spoke positively about the quality of service. They told us staff were caring and kind and sometimes went above and beyond what was expected of them.

People told us staffing levels met their needs. Staff were reliable and flexible and were committed to ensuring all visits were maintained. Staff were courteous and would ring if they were going to be late.

Arrangements were in place to protect people from risk of abuse. Staff had knowledge of safeguarding procedures and were aware of their responsibilities for reporting any concerns. During the course of the inspection we identified one incident which had been investigated by the Local Authority but had not been reported to the Care Quality Commission. The Service had followed its safeguarding policy but this did not meet Care Quality Commission Regulations. We have made a recommendation about this.

Systems were in place to check all staff employed had the required skills and were of suitable nature before they started working for the service.

Arrangements were in place for managing and administering medicines. People were encouraged to self-administer medicines where appropriate.

People’s healthcare needs were monitored and concerns regarding people’s health were fed back to relevant health professionals or the person’s relatives so action could be taken. Relatives said staff responded to health concerns in a timely manner.

Care plans were in place for people who used the service. Care plans covered support needs and personal wishes. People told us care plans were reviewed and updated at regular intervals. Information was sought from appropriate professionals as and when required. Staff providing direct care said they were encouraged to be involved in the reviewing of care needs of people and communicated all changes in needs to management.

The registered manager said they promoted person centred care through the development of individualised care plans. People told us they were consulted with when developing their care plans.

Staff had a good understanding of the Mental Capacity Act and how this impacted upon their work.

Staff praised training provided and told us development opportunities allowed them to carry out their tasks proficiently. The registered provider kept records of all staff training completed.

Staff said they were supported by management and described teamwork within the service as good. Staff were expected to visit the office on a weekly basis to collect and return all required paperwork. The registered manager said they used this opportunity to keep staff briefed and updated.

People who used the service and relatives spoke positively about the management of the service and the effectiveness of the care provided.

The registered manager had a complaints policy in place which gave clear instruction on how to manage complaints. They told us they had received some issues of concern but had not received any formal complaints to date. People told us whenever they expressed any concerns they were acted upon swiftly and treated seriously.

People said they were supported to meet their nutritional needs. Records were kept when support had been provided with eating and drinking.

The registered provider carried out formal quality audits, engaging with people who used the service on a regular basis. Feedback on service provision was positive.

We spoke with people being supported and their family members. They told us they received safe and appropriate care which was meeting their needs. They said the staff members who visited them were polite, reliable and very professional when undertaking their work. One person said, 'We have the same group of carers who visit my husband. They understand his needs very well and are very kind and patient with him. We have used a number of agencies before Bare Hall and didn't get the excellent service we are receiving now'. Another person said, 'I am very happy with the service I am receiving. I get first class attention from all the girls who visit me and have no complaints'.

During our inspection we contacted the Lancashire contracts monitoring team. They told us they currently had no concerns with the service being provided by the agency.

Without exception, everyone we spoke with felt they were treated with dignity and respect. One person said, "The carers always treat me with respect. They are polite and friendly. I feel happy and comfortable with my carers. They know me well." Another said 'They (care workers) are all very friendly, it's a pleasure to know them. I feel they really care and want to offer me support emotionally as well as the care tasks they do.'

The vast majority of people told us that the carers were nearly always on time. Sometimes if they were delayed, they would telephone, just to let them know they were going to be late. People said that they understood this and were reassured by the phone call.

Most people also told us the service was reliable with good continuity and consistency of care with a group of care workers that were known to them. They felt they had sufficient choices in the care provided. They told us they had been involved in the setting up of their care, and had been offered choices in the times of the visits.