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Bosworth Homecare Services Good

All reports

Inspection report

Date of Inspection: 29 May 2012
Date of Publication: 4 July 2012
Inspection Report published 4 July 2012 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Not met this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

Our judgement

The provider is not compliant with this standard. We judged this had a minor impact on people using the service and action was needed for this essential standard.

Although people’s needs were assessed their care was not always delivered in line with their individual needs as plans sometimes lacked sufficient detail.

User experience

A relative told us, “risk assessments in my home were done to make sure my electrics were safe for staff to use and general safety in the home. Manual handing for my relative was also done.”

Another relative said, “we have been able to choose the gender of the staff visiting our home and to provide personal care.”

Other evidence

We looked at two care plans. We saw people had a pre-assessment and a fuller assessment as part of the care process with the service. There were a number of detailed risk assessments. In both cases families were involved at the beginning of the care package but there was less written evidence of this as care continued to be provided. This means that staff would rely on verbal communications between themselves and from the person using services. This meant that any gaps in care may not be readily identified.

We saw care plans were completed but were not always tailored to meet the person’s

individual needs. They did not give staff sufficient detail to be able to know what to do for each person each time. For example, one person’s needs included, to be changed, washed and hoisted. The instructions told staff what they needed to do. It did not explain how to approach the person, how to explain what they were going to do or how long it was expected to take. The care plan did not set out if there were any special preferences that the person would like. This meant that in practice staff with limited experience of care could not fully meet the person’s needs as they may not have considered the person’s mental well being, social and emotional care needs.

Both care plans had risk assessments they were clear and easy to understand. They were reviewed by the agency. The reviews by the local authority were not regularly updated and the care package provided did not reflect the written care plans by them. This created delays in the funding for additional staff or for equipment.

Risk assessments were in place and included risks about falls or moving and handling. We saw staff were provided with procedures to follow. The care plans explained to staff what they needed to do to keep the person safe. We saw equipment was provided to help staff in their role. Hoists and specialised rolling sheets were considered. We also saw that as peoples’ needs changed the response by the agency and by the sponsors of care was slower than expected. In one case it took a long while for the third staff member to be provided and funded to assist with the moving and handling needs of a person using the service in their home. However, once an additional staff member was appointed to help staff were more able to manage their moving and handling needs.

We saw other specialist agencies were also asked to help and to be involved. These included the district nurses and the occupational health teams.

We were told about changes to the care plans being made with the agreement of the person using the service where this was possible or with a family member. However, we did not always see where this was included in writing.

Daily notes were maintained by staff that related to people’s needs. They were kept in people’s homes and after a month or sooner returned to the office for filing.

We spoke with five staff they had a good understanding of the Deprivation of Liberty Safeguards (DoLS) and the code of practice from the Mental Capacity Act 2005 (MCA). These safeguards aim to protect people receiving care and patients in hospital from being inappropriately deprived of their liberty. The Mental Capacity Act 2005 protects people who lack capacity to make a decision for themselves because of permanent or temporary problems such as mental illness, brain injury or learning disability. If a person lacks the capacity to make a decision for themselves, staff can make a decision in their best interests. The MCA sets out care providers' responsibilities, including a two stage test of the person's capacity to make particular decisions.