Br3akfree Limited

At our last inspection on 6 March 2017, the service was rated ‘Requires Improvement’. The service was in breach of regulations as the service had not completed assessments to determine people’s ability to make decisions in certain areas. During this inspection, we found improvements had been made and the service therefore has been rated ‘Good’.

The service had a registered manager. 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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is managed.

Risks had been identified, assessed and information had been included on how to mitigate risks to ensure people received safe care. Staff were aware of how to identify abuse and knew who to report abuse to, both within the organisation and outside the organisation. Medicines were managed safely. Medicine records were completed accurately and staff had been trained with medicines.

Pre-employment checks had been carried out to ensure staff were fit and suitable to provide care and support to people safely. Staff told us they had time to provide person centred care and there were appropriate staffing levels. There were systems in place to reduce the risk and spread of infection. Staff had been trained on infection control and were provided with personal protection equipment to ensure risks of infection were minimised when supporting people.

Staff had received the training required to perform their roles effectively. People were cared for by staff who felt supported. Spot checks had been carried out to observe staff performance to ensure people received the required care and support. Staff had been trained on the Mental Capacity Act 2005 (MCA) and knew the principles of the Act. Assessments had been carried out using the MCA principles. People’s care and support needs were assessed regularly for effective outcomes. The service worked with health professionals if there were concerns about people’s health. Staff could identify the signs people gave when they were not feeling well and knew who to report to.

Relatives told us that staff were caring towards people and that they had a positive relationship with them. People’s privacy and dignity were respected by staff. People were involved with making decisions about their care and were encouraged to be independent.

Care plans were person centred and detailed people’s preferences, interests and support needs. Care plans contained information on how to communicate with people. Pre-assessment forms had been completed in full to assess people’s needs and their background to determine if the service can support people. People participated in various activities with staff. Relatives knew how to make complaints and staff were aware of how to manage complaints.

Staff told us that the service was well led. Relatives and staff were positive about the registered manager. People and relative’s feedback was sought from surveys to identify ways to make improvements to the service. Quality assurance systems were in place, which enabled the service to identify issues and take prompt action when required to ensure people received safe care at all times.

On the 5 February 2016 we carried out an announced comprehensive inspection of the service. We found that the service did not have a robust recruitment system in place. We issued one requirement action. During this inspection we found improvements had been. Recruitment and selection procedures were now in place and appropriate checks had been undertaken before staff began work.

There was a registered manager at the service at the time of our inspection. 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 and associated Regulations about how the service is run.

Records clearly showed that relatives had been involved in the planning of personal care and activities for people who used the service. However the service had sought consent from relatives without ensuring they had the legal authority to consent on their behalf.

Systems were in place to help ensure people were safe. Staff had undertaken training about safeguarding adults and had a good understanding of their responsibilities with regard to this. Risk assessments were in place which provided information about how to support people in a safe manner. We found there were enough staff working to support people in a safe way in line with their assessed level of need. The service had arrangements for the management of medicines to protect people against the risks associated with medicines.

Staff received regular training and supervision and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people and their relatives were involved in making decisions about their care.

The registered manager was open and supportive. Staff and relatives felt able to speak with the registered manager and provided feedback on the service. The service had various quality assurance and monitoring mechanisms in place.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

There was a registered manager at the service at the time of our inspection. 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 and associated Regulations about how the service is run.

The service did not have a robust recruitment process because Disclosure and Barring Service (DBS) checks had been requested but not returned for two staff members working in people’s homes. Also the provider’s recruitment stated two references were required before staff commenced work however one member of staff had started work with one reference only.

We made a recommendation about spot checks being recorded.

Systems were in place to help ensure people were safe. Staff had undertaken training about safeguarding adults and had a good understanding of their responsibilities with regard to this. Risk assessments were in place which provided information about how to support people in a safe manner. Staff understood their responsibilities under the Mental Capacity Act 2005. We found there were enough staff working to support people in a safe way in line with their assessed level of need. The service had arrangements for the management of medicines to protect people against the risks associated with medicines.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people and their relatives were involved in making decisions about their care.

The registered manager was open and supportive. Staff and relatives felt able to speak with the registered manager and provided feedback on the service. The service had various quality assurance and monitoring mechanisms in place.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.