Background to this inspection
Updated
12 January 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was partly prompted by an incident which had a serious impact on a person using the service and this indicated potential concerns about the management of risk in the service. This inspection examined those risks.
Inspection team: One inspector, one pharmacy inspector and one expert by experience (ExE), who telephoned people in their homes to gain their view of the service, carried our this inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type:
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the provider 24 hours’ notice of the inspection visit because it is small. We needed to be sure that someone would be available to assist us.
What we did:
We reviewed information we had received about the service. This included details about incidents the provider must notify us about, such as abuse; and we sought feedback from the local authority and professionals who work with the service. We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection we spoke over the telephone with 10 people using service and six relatives. We visited one person in their own home and whilst there spoke with a relative. We spoke with the registered manager and two staff members. Various records were reviewed, in relation to training and supervision of staff, the management of the service and a variety of policies and procedures developed and implemented by the provider.
Updated
12 January 2019
About the service: Brookleigh is a domiciliary care agency that provides care and support to people in their own homes. Not everyone using Brookleigh Caring Service - Gloucester House received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks relating 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 provided care and support for 19 people.
People’s experience of using this service:
People's risk assessments did not consistently cover all potential areas of risk, such as diabetes, choking and nutrition and did not consistently mitigate risks. We looked at the systems in place for medicines management and found they did not always keep people safe.
The providers systems and processes in place to monitor and audit the service required improvement. Records management needed improvements regarding medicines, risk assessments and quality monitoring of the service.
People told us they felt safe in the care of staff members and were happy with staffing levels. The provider had appropriate systems in place to support staff to raise any safeguarding concerns. Staff had access to appropriate personal protective equipment (PPE) to help prevent the spread of infection.
People told us they received effective support. Systems were in place to ensure that staff received
appropriate supervision to support them in their roles. Staff felt they were trained to the right level to effectively work with people.
Checks were made on the ongoing competency of staff and staff felt they could ask for extra training and support at any time. People told us that staff sought their consent prior to carrying out care and they made them aware of the actions they were to take. People were supported to eat meals of their choosing and were supported to access health professionals when necessary.
People told us care staff were very caring, kind and compassionate. Staff enabled people to be independent and to make choices where possible. People's privacy and dignity needs were maintained by staff members caring for them.
People told us they were provided with a responsive service. People received care and support which was assessed, planned and delivered to meet their individual needs. People and families spoke about being involved in the process of writing and reviewing their care plans. People knew how to make complaints and we saw evidence to show closed complaints had been fully investigated.
More information is in the detailed findings below.
We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around governance and keeping people safe. Details of action we have asked the provider to take can be found at the end of this report.
Rating at last inspection: This was the first inspection of the service.
Why we inspected: Although the service was due their comprehensive first inspection, the inspection was partly prompted by an incident which had a serious impact on a person using the service and that this indicated potential concerns about the management of risk in the service. While we did not look at the circumstances of the specific incident, we did look at associated risks.
Follow up: We will speak with the provider following this report being published to discuss how they will make changes to ensure the service improves their rating of the service to at least Good. We will revisit the service in the future to check if improvements have been made.