Archived: Beacon Homecare Services Limited

Beacon Homecare Services Limited is a domiciliary care agency providing personal care for people living in their own homes in the Penrith area of Cumbria. The service supports older people, people living with a dementia, physical disability or mental health need. They also support people who misuse drugs and alcohol.

Not everyone who used the service received personal care. Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating.

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

At the last inspection the provider had not made sure the governance systems were sufficiently effective to monitor and improve the quality and safety of the service. Since then there had been improvements in the way the management team carried out audits to check the quality of the service.

People and relatives said the service was safe and they trusted the staff. They described staff as “pleasant, courteous and friendly”. People said the service was reliable. Staff arrived on time and stayed the full amount of time.

Risk assessments and care records were more personalised so staff had detailed information about how to support each person in the safest way.

People said staff made sure they wore masks, aprons and gloves to prevent the spread of coronavirus. Staff had updated training in infection control and felt supported by the provider during the pandemic.

People said staff understood how they wanted to be supported, listened to them and did what they asked. They commented the care service was personalised and met their individual preferences and needs. People described the service as “flexible” and “accommodating” whenever they asked for any changes.

People had information in ways they could understand. They felt confident about raising any issues. The service had not received any complaints or concerns since the last inspection.

People and relatives said the service was well-managed. They found it easy to contact the office and there was always someone available to take their call. People said they were asked for their feedback and office staff visited to check their care from time to time.

People and staff said the management team were open, approachable and supportive. The registered manager was committed to continuous improvement of the service.

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 last rating for this service was requires improvement (published 23 October 2019) and there was a breach of regulation relating to good governance. At this inspection we found improvements had been made and the provider was no longer in breach of regulation.

Why we inspected

We carried out an announced comprehensive inspection of this service on 11 September 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe, Responsive and Well-led.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Beacon Homecare Services Limited on our website at www.cqc.org.uk.

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.

Beacon Homecare Services Limited is a domiciliary care agency providing personal care for people living in their homes in the Penrith area of Cumbria. The service supports older people, people living with a dementia, physical disability or mental health need. They also support people who misuse drugs and alcohol.

Not everyone who used the service received personal care. 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. At the time of our inspection 69 people were receiving the regulated activity of personal care.

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

There was no robust, effective system in place to monitor and drive quality improvement in relation to care records which presented a potential risk to people.

We have made recommendations about the assessment of risk, personalised care planning and end of life care planning. Risks had been identified however assessments were not specific to the person and were generic in nature. There were no systems used to analyse incidents or events to identify any triggers or lessons learnt.

Care records included some information about people’s preferences, and their personal history. There was limited information about the support people needed and the strategies staff should follow when providing care and support.

The service supported people who were nearing the end of their lives. Care plans did not contain any information about people’s wishes and preferences about the support they wanted at the end of their lives.

A procedure and guidance document was in place for staff to follow in relation to the Mental Capacity Act (2005). 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 said they were well supported by the registered manager and were well trained

Staff were very knowledgeable about people’s needs and preferences and knew how to provide safe care and support. Due to staff knowledge the above concerns had not impacted on the care people received. People told us they felt very safe. Comments included, “The care I receive is very good” and “Staff are great I can’t fault anyone.”

People were involved in making decisions about their care and regular reviews were held to gain people’s feedback.

Safe practices were followed in relation to the recruitment of staff and the management of medicines.

People were supported to access healthcare services when needed and staff took appropriate action following any accidents or incidents. Positive feedback was received from external professionals about the care provided.

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

Rating at last inspection

The last rating for this service was good (published 17 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to good governance and quality monitoring at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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.

Beacon Homecare Services Limited provides personal care and support to adults living in their own homes. The agency is based in Penrith and provides support to people in Penrith and the surrounding areas. Services offered by the agency include personal care, shopping, housework and preparing meals.

There was a registered manager employed at the service. 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.

People received support from staff who they knew and who had the skills and knowledge to provide their care. The staff were kind and friendly and people looked forward to their visits. There were enough staff to provide support as people needed. All new staff were checked to make sure they were suitable to work in people’s homes.

People were safe because hazards to their safety had been identified and managed. Staff were aware of how people could be at risk and took action to protect people from abuse.

People were supported to maintain their independence and to remain in their own homes. This was very important to them and they valued the support they received.

Medicines were handled safely and people received the support they required to maintain their health. People received the support they needed with preparing their meals and drinks.

People agreed to the support they received and their wishes and rights were respected.

The service was well managed. There were appropriate arrangements to ensure the effective management of the agency. People knew the members of the agency’s management team and said they were friendly and helpful. The registered manager responded promptly if people raised concerns and resolved these to their satisfaction.

People were asked for their views and action was taken in response to their comments. The management team monitored the quality of the service and took action where they identified areas that could be further improved.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found.

Is the service safe?

Systems were in place to help make sure that the service learned from events such as accidents, incidents, complaints and investigations. This helped to identify any risks and helped the service to improve.

The registered manager set the staff rotas. They took into consideration people's care needs when making decisions about the numbers, skills and experience of the staff required. This helped to make sure people's needs were met appropriately and safely.

Staff recruitment practices were safe and thorough. We found that appropriate checks had been carried out before staff started working with people who used this service. Policies and procedures were in place with regard to staff recruitment, discipline and staff supervision. These procedures helped to make sure people were protected and supported with their needs safely.

Is the service effective?

We saw examples of people's care plans during our visit to the service. We found that they had been regularly reviewed and updated when necessary. The people we spoke to about their experience of Beacon Homecare confirmed that they had copies of their care plans and that 'people from the office' came out to see them to make sure everything was 'all right'. One person told us, 'If there are any changes, they always make sure the staff are aware of them. New care plans are provided quickly in the event of changes'.

One of the social care professionals we spoke to told us, 'They are very good at supporting people who can be challenging or want to live in a particular way. They have provided incredible support to one of my service users'.

Is the service caring?

We spoke to six people who used this service. We asked them for their opinions about the service and the staff that supported them. The feedback we received was positive, for example; 'I cannot fault them (care staff) they are so caring and dependable', 'They go above the call of duty sometimes, they are very good' and 'The staff look after my relative very well. They take their time and don't rush'.

We spoke with some of the staff that worked at this care service. It was evident that they knew the people they supported very well and cared about their wellbeing. Staff knew about people's individual needs and had access to care plans and risk assessments within the homes of the people they supported.

Is the service responsive?

The people we spoke with knew how to raise a concern or complaint if they were unhappy. Most of the people we spoke to did not have any concerns or complaints about the service. One person told us that there had been 'little hiccups' but that these had been 'sorted out quickly when brought to the attention of the people in the office'.

One of the social workers we spoke to told us that the service was always 'quick to respond to requests when service was needed.'

Is the service well-led?

The service had a quality assurance system in place. The sample of records and information we looked at showed that any problems identified had been dealt with quickly. We (CQC) had identified some shortfalls in the quality of the service at our last inspection in October 2013. The provider developed an action plan showing how and when the issues identified would be addressed. We found that the provider had made the improvements we had asked them to make.

The staff we spoke to told us about their roles and responsibilities. They told us about the systems that were in place to monitor their practice and help them with their professional development.

The people we spoke to told us that they had a copy of their care plan in their home. They told us that people from the agency came to check that their care and support needs were being met appropriately. People told us that their care workers usually turned up at the times expected. However, everyone we spoke to told us that they received their care from lots of different care workers. One person said, "I don't always know who I am getting and I don't like this." Another person told us, "There is very little continuity. It would be nice if we could have the same few carers."

Everyone we spoke to was complimentary about the care workers that did attend them. Staff were described as "Very good, respectful and nice." One person said, "The senior carer who attends is a lovely little lass, she always has a smile on her face."

People who used the service said that they felt "safe" with their care workers and knew who to contact at the agency if they ever had concerns or a problem. The owners of the agency were described as "Very approachable".

There were some areas of concern that the provider needed to deal with quickly to make sure that people who used this service were safe and protected from the risks of harm.

We found that the provider did not always tell us about concerning incidents that had occurred at the agency. Staff knowledge was not up to date with regard to safeguarding people from abuse and there were gaps in the processes used to recruit new workers to the agency.

Everyone we spoke with told us they felt safe receiving care from the service and that it was "reliable" and one person told us that "They are excellent and really lovely" with their relative and the care they gave. People using the service also confirmed that they knew who was coming to visit them in advance and there was good continuity with staff who knew them well. People told us they knew who they could speak to if they had a concern or complaint and said they would be confident raising concerns with the manager of the agency.

We found that the agency was well organised. The provider had systems in place to identify, assess and manage risks and to ensure that care was delivered effectively and to people's satisfaction.