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Archived: Brook Domiciliary Care Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 24 April 2018

This inspection of Brook Domiciliary Care Ltd was carried out on 24 January 2018 and was announced. This was the first inspection of this service under its current registration.

Brook Domiciliary Care is a domiciliary care agency. It provides personal care to people living in their own homes and flats. It provides a service to older adults, younger adults, people living with dementia and people with a sensory impairment. Not everyone using Brook Domiciliary Care received a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care', such as help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

Brook Domiciliary care provided the regulated activity of personal care from an office based in Ilford, Essex. At the time of this inspection, 50 people were using the service. All the people who used the service received direct payments from the local authority and had chosen to use the service.

A registered manager was 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.

Staff supported people at home with their care needs and the service had assessed some risks. However, not all risks associated with people’s health care tasks had been assessed to ensure they were safe at all times, when staff carried out personal care. Although people received their medicines, records maintained by the service were not always clear, regularly reviewed and appropriately maintained by the service.

Quality assurance systems were in place but were not always effective. The audits, which the service carried out, had not identified the shortfalls we found during the inspection to ensure people received a consistently safe service.

Care plans were inconsistent. Some care plans did not include the support people would require in relation to their current circumstances. Care plans contained information on how to communicate with people. Pre-assessment forms had been completed in full to assess people’s needs and their background. Reviews were being carried out regularly. We have made a recommendation for the registered manager to review and update all the care plans with regard to supporting people based on their condition and current circumstances

People received safe care. Staff recruitment processes were followed and ensured that people were protected from being cared for by unsuitable staff. There were enough staff to provide care and support to people to meet their needs safely. Staff were trained in procedures to support and protect people from abuse.

People were supported to maintain good health and nutrition. Staff were equipped with sufficient personal protection equipment to reduce the risk of infection and cross contamination when supporting people with their personal care.

People received effective care and support. Staff received induction and on-going training for their role and understood their responsibilities to perform their roles effectively.

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 received good care from staff. They had developed positive relationships with the staff who understood their needs. Staff were kind, caring and treated people with dignity and respect.

Staff worked in a flexible way which promoted continuity of care so that they could meet people's needs in a person centred way. The registered manager ensured the management team provided staff with the support they needed.

People knew how to raise a concern or to m

Inspection areas

Safe

Requires improvement

Updated 24 April 2018

The service was not always safe.

Most risk assessments set out how to manage and reduce the risks people faced. However, some risk assessments did not cover all the risks relating to people’s specific condition.

Medicines management was not clearly recorded in care plans leaving people at risk of not getting their medicines in a safe way.

Staff were able to explain to us what constituted abuse and the action they would take to raise concerns.

Relevant pre-employment checks were carried out when recruiting staff. Adequate number of staff were deployed to meet people’s needs.

Effective

Good

Updated 24 April 2018

The service was effective.

Staff received sufficient training, supervision appraisals to support them in their role.

Staff were aware of the principals of the Mental Capacity Act (2005) and understood how it was applied. They asked for people's consent before providing care and support.

Assessments of people’s needs were carried out to ensure effective outcomes for their care. Staff were informed of changes in people’s care needs.

People’s nutritional needs were met.

Staff supported people to access health care professionals when needed.

Caring

Good

Updated 24 April 2018

The service was caring.

People and their relatives told us that they were treated well and staff were caring. People could make choices about how they wanted to be supported and staff listened to what they had to say.

People were treated with respect and staff understood how to provide care in a dignified manner and respected people’s right to privacy.

Responsive

Good

Updated 24 April 2018

The service was responsive.

Care plans were in place and included details about how people wanted their care to be delivered. However, the plans did not include the support people would require in full as they did not always include people's specific conditions and how these needs were to be met by staff.

People knew how to make a complaint if they were unhappy about the service and felt confident their concerns would be dealt with appropriately.

Well-led

Requires improvement

Updated 24 April 2018

The service was not always well-led.

Although quality assurance and audit processes were in place to monitor the service, the systems were not sufficiently robust because shortfalls were not always identified and acted upon to make improvements.

People were encouraged to provide feedback on the quality of the service they received.

Staff felt supported by the provider and involved in developing the service.

The provider worked in partnership with other services to ensure they supported people in a safe and consistent way.