Archived: Best At Home Domiciliary Care Services Ltd

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:

There were no quality assurance processes in place for the registered manager to review the audits taking place. We made a recommendation about this.

Risks to people's health and safety were not always sufficiently assessed and more guidance was required for staff on how to mitigate the potential risks to people. Although care records reflected people’s preferences and choices, some additional information was required on how to support people with personal care and at the end stages of their lives.

Staff followed provider’s procedures if they noticed people being at risk to harm. People were assisted to manage their medicines safely. Staff were required to undertake appropriate checks before they were employed by the provider. Systems were in place to ensure hygienic care for people.

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 knew the actions they had to undertake should they noticed people’s health needs deteriorating rapidly. People were assisted with their meal preparations as necessary.

People felt respected by the staff that supported them. Staff encouraged people to maintain their independence skills where possible. People were provided with information, so they could make choices and decisions for themselves as necessary. Personal information about people was securely stored.

Staff encouraged people to engage in conversations and used their preferred ways of communication. People and their relatives felt confident to raise any concerns they had which were addressed by the service to the satisfaction of the complainant.

People and relatives told us there was good leadership at the service which ensured that their views were adhered to as necessary. We found the registered manager transparent and caring about people’s wellbeing. The staff team worked together with the families to ensure person-centred care delivery for people. Support and guidance was provided for staff to ensure they performed their duties well.

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 10 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Best At Home provides personal care to people living in their own homes. They currently provide personal care to ten people. The provider generally takes referrals from the Clinical Commissioning Groups (CCG’s) and offers personal care to people who are nearing the end of their life. The provider also accepts other groups of people who need personal care although this currently represents a small number of people.

The service had a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

Care workers knew how to keep people safe from harm and what action they should take if they considered anyone was at risk. Where the service had identified risks to people, they put measures in place to minimise them and help prevent re-occurrences. The provider undertook a number of checks prior to employing new staff to make sure only suitable staff were employed.

Care workers received training and support to make sure the care they provided was in line with best practice and met people’s needs. They sought consent and knew how to maintain people’s privacy before providing personal care.

People told us the registered manager was approachable and if they had any issues or concerns they would be able to raise them, and that they would be listened to and taken seriously. The registered manager undertook a range of checks and audits to continually monitor the quality of the service.

The provider worked carefully to ensure there was continuity of care with the same care workers visiting people. Support plans were reviewed regularly so they reflected people’s changing needs.

The provider routinely monitored people’s health, which included ensuring people were getting enough to eat and drink. People received their medicines safely.

The registered manager understood the people they worked with were nearing the end of their lives and needed particularly sensitive and compassionate care. They also understood the impact this work could have on care workers and therefore offered additional support to them. The registered manager was aware of their responsibilities to inform CQC of significant events.