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Archived: Better-Care Domiciliary Services Limited

Overall: Requires improvement read more about inspection ratings

Room 8, 30 Boutport Street, Barnstaple, Devon, EX31 1RP (01271) 314716

Provided and run by:
Better-Care Domiciliary Services Limited

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Background to this inspection

Updated 30 May 2018

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.

This service was a domiciliary care agency. It provided personal care to people living in their own houses and flats. Not everyone who used Better-care received a regulated activity; the Care Quality Commission (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.

The inspection site visit took place on 6 March 2018 and was announced. Inspection site visit activity started on 1 March and ended on 16 April 2018.

We gave the service 24 hours’ notice of the inspection visit because it was small and the registered manager was often out of the office supporting staff or providing care. We needed to be sure they would be in. We visited the office and spoke with the registered manager, the provider, a team leader and office staff.

This was a routine comprehensive inspection and the first inspection carried out by the CQC since the service was registered on 12 December 2017.

The inspection was informed by feedback from questionnaires completed by a number of people using the service prior to the inspection taking place. CQC sent surveys to: five people and received three responses; five relatives and received no responses; nine staff and received six responses, and ten community professionals and received three responses.

We used information the provider sent us in the Provider Information Return (PIR). This is 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 also reviewed other information we held about the service. This included safeguarding alerts and statutory notifications. A notification is information about important events which the service is required to send us by law.

We visited three people in their homes and spoke with them and their relatives. We reviewed information about people's care and how the service was managed. These included: four people's care files and medicine records; three staff files which included recruitment records of the last staff to be appointed; staff rotas; staff induction, training and supervision records; quality monitoring systems such as audits, spot checks and competency checks; complaints and compliments; incident and accident reporting; minutes of meetings and the most recent quality questionnaire returned.

Overall inspection

Requires improvement

Updated 30 May 2018

This announced comprehensive inspection on 6, 26 and 27 March 2018. On the first and second days, we visited the office and reviewed the systems for managing the service. On the third day, we visited three people who used the service in their own homes.

On 28 March 2018, we received notification from the commissioners of the service that the service had contacted them and had given them written notice of their intent to close the business. An action plan was drawn up between the service and the commissioners as to how to do this. This took into account the best interests of the people and staff working for the service. The service end date was agreed as 20 May 2018.

At the time of writing this report, the agency was no longer providing a service. Notifications had been received by the Care Quality Commission (CQC) with a voluntary application to deregister the service which was in the process of being dealt with.

This service was a domiciliary care agency. It was registered with CQC to provide personal care to older and younger adults living in their own houses or flats. These people might have lived with dementia, a mental health illness, a drug and alcohol illness, an eating disorder, a physical disability or a sensory impairment. There were 20 people using the service at the time of inspection.

There was 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager has submitted their voluntary application to deregister their role at the service.

People were happy with the service they received. People had built up meaningful relationships with the care workers who supported them and felt comfortable with them in their homes. People described care workers as kind and caring.

People were kept safe and cared for by staff who had been safely recruited, trained and supervised in their work. They had undertaken training in the protection of vulnerable adults and medicine management.

There was sufficient staff to meet people’s needs with no missed visits. However, the service relied upon other registered services at times to fill in gaps they could not cover in people’s care, particularly at weekends. This had been agreed with the commissioners of the service.

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. Care workers had received training on the Mental Capacity Act 2005. They ensured people were asked for their consent before they carried out any care or support. The service complied with the accessible information standard which included information about how to communicate with people in their individual ways.

Each person had risk assessments and a care plan in place. However, these were variable and were not always person centred or fully completed. This made it difficult for staff to provide care and support in a consistent way. However, staff always ensured people received their planned care in the way they chose.

People were supported to eat a nutritious diet and food and drink of their choice. In between care visits, care workers always made sure people had snacks and drinks available. People were encouraged to maintain their independence as much as possible and care workers encouraged them to maintain their health and wellbeing. Health and social care professionals were involved where necessary.

There were some quality monitoring systems and processes in place. However, these needed to be improved to ensure continuous development of all aspects of the agency. There was a complaints policy in place.

We made one breach of Regulation in relation to the management of the service.