We carried out a review of the data available to us about B Pro Nursing Agency on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about B Pro Nursing Agency, you can give feedback on this service.
B Pro Nursing Agency is a domiciliary care service which provides personal care to older people living in their own homes. At the time of the inspection the service was supporting 19 people.
People’s experience of using this service and what we found
The previous inspection in November/December 2019 found people's medicines were not always managed safely, there was no system for monitoring missed and late calls, personal protective equipment (PPE) was not always available and staff were not sufficiently trained for the role, especially in relation to end of life care. Staff reported a negative culture in the service and there was a lack of governance and oversight.
At this inspection we found improvements had been made to ensure people received their medicines safely, staff were trained to deliver high quality care, the culture of the service was positive and management systems were in place to monitor the quality of the service
People and their family members told us they received care and support which was reliable and consistent from caring staff. Rotas were organised in a way which meant people saw the same team of staff so that relationships were developed and maintained.
Staff had a good understanding of safeguarding processes to keep people safe and how to report any concerns. Staff understood and were aware of their responsibilities to raise concerns and report all incidents. People told us they received their medicines when they needed them. We were assured the service met good infection prevention and control guidelines and PPE was readily available. There were enough staff to provide care and support to people and staff had been suitably recruited to their role.
Staff were aware of people’s needs and supported them to manage risks to their safety whilst supporting them to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.
People’s needs had been assessed before using the service. Care plans contained comprehensive information about people’s needs and ways in which they should be met. This included their routines, preferences and wishes. People had received end of life care from staff who were trained, sensitive and compassionate.
Staff confirmed they had received training that gave them the knowledge and skills to carry out their roles. Spot checks were carried out to monitor staff practice and ensure they were working safely. People had good support with their meals. People were supported to access healthcare where needed. Staff worked well with other professionals to ensure people’s healthcare needs were met
Staff treated people with dignity, respect and kindness. Staff had a good understanding of people's individual lifestyles and culture and respected people’s right to privacy, confidentiality and promoted their independence. Staff recorded information about people in a respectful way.
Systems had improved to assess, manage and monitor the oversight and quality of the service. Complaints were investigated and responded to. Where things had gone wrong, the registered manager and care coordinator was open and transparent with people, and their relatives and used their feedback to improve 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 16 March 2019) and where we identified breaches of the regulations and made recommendations for the service to improve. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvement had been made and the provider was no longer in breach of the regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
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.
B Pro Nursing Agency is a domiciliary care agency providing personal and nursing care to 17 people of all ages at the time of the inspection. Not everyone who used the service received personal care. 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.
People’s experience of using this service and what we found
We have made recommendations about managing peoples medicines,
people being treated with kindness and respect, what people should do if their carer hasn't arrived and training for end of life care.
The service was not well-led. The provider had failed to ensure adequate oversight of the service.
People told us the service was chaotic and disorganised.
Staff did not feel valued or listened to or supported through supervision. There was a negative culture at the service.
The provider did not have robust and effective systems and processes to ensure the quality and safety of the service.
People told us staff knew how to provide care for them but sometimes lacked training and experience. The training and induction in place was not robust enough to support staff to carry out their roles meaning staff were reliant on previous training.
People and their relatives gave us mixed feedback about how safe they felt. The service was not always run safely; the provider had not always managed medicines in a safe way, problems with rotas had led to late and missed calls. Staff knew how to recognise signs of abuse and keep people safe.
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. Peoples care plans were personalised and recorded peoples likes and dislikes.
People told us their carers were kind and friendly. People knew how to make a complaint if required. Staff explained how they supported people's independence and respected their diversity.
The provider met people's hydration and nutritional needs and supported people to get medical treatment where required.
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 compliant (published 12 July 2013) This service entered a period of dormancy until August 2017.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to staff training and governance of the service 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 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.
Feedback from the provider's quality assurance questionnaire included 'The girls have been fantastic ' I have no words to explain my gratitude,' 'Everything is perfect from BPro,' '(person's name) is just right for me, she is thorough in her work and I get exactly the help I need,' ' (person's name) has been a fantastic support to both my husband and myself and I have every confidence in BPro Care' and 'up to date I feel the service from BPro Care has been excellent, myself, my children and family members are very happy with the care provided, which has helped to give us all a better quality of life.'
Those spoken with confirmed they had been able to make decisions about their care and how they wanted this to be provided, although the assessments viewed during the visit did not always reflect the care plans in place.
People spoken with had been made aware of the complaints procedure and confirmed they had received written documentation during the assessment. They added that they felt that they could raise any concerns they may have with the management.
People knew how to raise any concerns they may have about the service and were generally very positive about their care.