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Reports


Inspection carried out on 21 September 2018

During a routine inspection

Always Caring Bromley Limited is a domiciliary care agency. It provides personal care and support to people in their own homes. Not everyone using Always Caring Bromley Limited receives the regulated activity; personal care. 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 take into account any wider social care provided. At the time of the inspection the service was providing personal care support to four people.

This inspection took place on 21 September 2018. We gave the provider two days’ notice of the inspection as we needed to make sure the manager would be available. At our last inspection of the service on 27 May and 01 June 2016 the service was rated Good. At this inspection we found the service remained Good. The service demonstrated they continued to meet the regulations and fundamental standards.

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.

Risks were assessed, managed and reviewed to ensure people’s needs were safely met. Detailed guidance for staff on managing risks were correctly documented. Accidents and incidents were recorded, managed and acted on appropriately. Appropriate recruitment checks took place before staff started work. There were enough staff to meet people’s needs when required. There were systems in place to ensure people were protected from the risk of infections. Medicines were managed and administered safely. There were safeguarding policies and procedures in place and staff knew what actions to take to protect people from possible harm.

Assessments of people’s care and support needs were conducted and documented. Staff completed an induction when they started work and received appropriate training, supervisions and appraisals. 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. People were supported to meet their nutritional needs where appropriate and people were supported to access health and social care professionals when required.

People told us staff were caring and respectful. People were consulted about their care and were provided with information about the service in a format that met their needs. People received personalised care that met their diverse needs. Assessments allowed for people to document any end of life care needs and wishes they had, should they so wish. People knew about the provider’s complaints procedure and how to raise concerns.

There were systems in place to assess and monitor the quality of the service provided. The provider considered the views of people using the service and there was an out of hours on call system in operation that ensured support and advice was always available. Staff worked closely with health and social care professionals to ensure people received good quality care. Staff told us they felt supported by the registered manager and had access to on-going support and training. The registered manager attended meetings with the local commissioning authority and attended the local authorities’ provider’s forum to support shared learning and to help drive improvements.

Inspection carried out on 27 May 2016

During a routine inspection

This inspection took place on 27 May 2016 and 01 June 2016 and was announced. Always Caring Bromley is a domiciliary care agency that provides support and personal care to people in their own homes. At the time of the inspection, approximately 16 people were receiving care and support from the service. The service has a contract with the local authority to provide personal care to people within the London Borough of Bromley and some people who use the service also organised their care and support privately.

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 and associated Regulations about how the service is run.

People said they felt safe and that staff treated them well. The provider had safeguarding policies and procedures in place and staff had a clear understanding to safeguard people in their care. There were safe recruitment and selection processes in place before staff started working with the agency. Appropriate numbers of staff were deployed to provide safe care and support. Risk assessments were carried out and where risks to people were identified appropriate action plans were in place to minimise or prevent the risk. People were supported to take their medicines as prescribed by healthcare professionals.

Care workers sought consent from people when they provided them with support. The provider worked within the requirements of the Mental Capacity Act 2005. People were supported to maintain balanced diets by eating and drinking sufficient amounts for their wellbeing. Where required, people had access to healthcare professionals. Staff were supported through induction, training and supervision to ensure they had appropriate skills and knowledge to perform the role which they were employed to undertake.

People’s privacy and dignity were respected and their independence promoted. People were consulted about their care and support needs. People were provided with appropriate information and knew how to contact the provider when needed. Each person using the service had a care plan in place which provided staff with information on how to meet their care needs. Staff understood people's needs and supported them in a caring way. People knew the provider had a complaints procedure and told us they were confident that any complaints they had would be listened to, investigated with appropriate action taken where needed.

The provider had appropriate systems in place to monitor the quality of the service. People’s views were sought though telephone monitoring calls and quality checks. Supervisors also carried out unannounced spot checks to ensure that the care delivery was in line with the care planned for. Staff said they were happy working with the agency and that they found their managers’ friendly and supportive.

Inspection carried out on 1, 2 May 2014

During a routine inspection

We gathered evidence against the outcomes we inspected to help answer our five key questions. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People using the service told us they felt safe. They said staff always wore their uniforms and ID badges, this meant they could be easily recognised. Safeguarding procedures were robust and staff understood how to safeguard people they supported.

There was a matching process in place that ensured that each person using the service was supported by a member of staff who had the specific skills and experience to meet their needs. A member of staff said “the agency makes sure I have the right training so that I can support the people I provide care to”, another member of staff said “The agency makes sure I am properly trained. They match our skills and experience with the needs of the people we support”. They also said the agency had a twenty-four hour on call service for dealing with emergencies and issues such as staff absence or sickness.

Is the service effective?

All of the people using the service and relatives we spoke with told us they had been consulted about their or their relative’s health and care and support needs. We saw that care plans and risk assessments recorded the specific needs of the person using the service and what staff needed to do to support them. We also saw that these care plans and risk assessments had been kept under regular review by the agency.

The agency carried out spot checks on staff to make sure they turned up on time, wore their uniforms, carried their identification cards and completed the tasks as stated in people using the services care plans. We saw that records of spot checks on care staff were kept in staff files.

Is the service caring?

We spoke with six people using the service. We also spoke with the relatives of two of these people. We asked them for their opinions about the staff that supported them. Feedback from people was positive, for example a relative said “I am satisfied with the agency. They always turn up on time and do what they have to do. They treat my husband with respect and they respect our home”. A person using the service said “I cannot speak highly enough of the agency. I got out of hospital five weeks ago and it was arranged for them to support me for six weeks. They have been ever so kind. I will be sad when I have to stop using them”. Another relative said “The carers carry out tasks with politeness and consideration. They sometimes go beyond the call of duty. For example they might pick something up from the pharmacist for us or drop a prescription off to the GP practice”.

Is the service responsive?

People using the service and their relatives told us they knew how to make a complaint if they needed to and they were confident that the agency would listen to them if they had to make a formal complaint and they were sure that their complaints would be fully investigated and action taken if necessary.

We saw that feedback from people using the service was captured through quality check visits and telephone monitoring calls. Feedback from these checks was used to make improvements at the agency.

Is the service well-led?

We found there were effective systems in place to regularly assess and monitor the quality of service that people received.

Staff told us they enjoyed working at the agency, there was good teamwork and they were well supported by the registered manager and the registered provider. They told us they had completed an induction, they had received lots of training and they had received regular supervision.

Inspection carried out on 16 April 2013

During an inspection to make sure that the improvements required had been made

When we inspected the service in July 2012 we found the provider did not always record detailed information about needs and risk and the provider did not document action taken as a result of issues identified by quality monitoring systems. At our inspection of 16 April 2013 we found that the provider had taken action to address the majority of these issues, and that people had detailed care plans to guide the staff supporting them.

People we spoke with or their representatives told us the care they received was good; one person told us their care staff were "wonderful". Another person told us their family member “gets care that meets their needs”.

Quality monitoring systems in place documented the actions taken to address any feedback from staff or people, and the provider had a complaints procedure in place and promoted its use. People told us they mainly had regular carers and there were no real problems with punctuality. We found that the provider had a recruitment policy in place which was followed on most occasions.

Inspection carried out on 18 July 2012

During a routine inspection

People told us the carers treated them very well and they were generally happy with the service.