Beverley Martins Limited

Beverly Martins Ltd is a domiciliary care agency which provides personal care and support to people living in their homes. Not everyone who used the service received personal care. The Care Quality Commission (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.

At the time of our inspection the provider was supporting 135 people in the London Boroughs of Lambeth, Lewisham and Croydon.

People’s experience of using this service

The provider had improved the way it assessed and mitigated risks to people’s safety and wellbeing. Systems were in place to safeguard people from abuse or harm. People’s medicines were being managed safely by trained staff.

The provider had improved the care plans which now contained detailed information about people’s health and social care needs. People and their representatives were actively involved in the formation and review of their care plan. Staff ensured people’s nutrition and hydration needs were safely met. The provider ensured staff received training and ongoing support.

People told us they received care from familiar staff who understood them well and staff were kind and caring. We received comments such as, “I have lovely carers who come four times a day” and “Staff always so nice, very caring, very tidy and top-class.” People’s privacy and dignity was upheld. Staff helped maintain people’s independence wherever possible and care plans contained good information to ensure staff worked in a consistent way.

The provider had improved the quality assurance processes to ensure the service was run effectively and safely. We received positive comments from people receiving care about the management of the service. People told us, “I would recommend Beverly Martins, the staff are all good and well trained” and “Yes, they are very good people. I wouldn’t be here without them.” The provider worked with a range of health and social care professionals to achieve positive outcomes for people receiving care.

Recruitment processes did not fully meet current requirements We have made a recommendation about the recruitment policy.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 24 April 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating. The overall rating for this service has changed from requires improvement to good.

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.

This service is a domiciliary care agency. It provides personal care for people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of the inspection they were supporting approximately 200 people. Not everyone using Beverley Martins receives a regulated activity. The Care Quality Commission 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.

At the time of our inspection there was no registered manager at the service. 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. However, a manager had been appointed and was in the process of applying for registration with the Care Quality Commission.

Risk assessments and care plans contained limited information for care staff. We saw many examples of incomplete or unclear risk management guidance within people’s care records. Therefore, we could not be assured that people were protected from avoidable harm.

Medicines were not always accurately recorded when care workers administered them, so it was not always possible to determine what medicines people had taken and when. People’s medicines care plans were not always clear about what support people needed.

There were appropriate safeguarding processes in place and care staff had a good understanding of their responsibilities.

The provider was not always meeting its obligations under the Mental Capacity Act 2005. Records were not always signed by the person using the service or their legally authorised representative. We also saw an example of a mental capacity assessment that did not conclude whether or not the person had capacity. Therefore, we could not be assured that people’s rights were being protected.

People’s care records did not contain sufficient information about their health and nutritional needs. We therefore could not be assured that people were consistently provided with the support they needed.

People told us there a lack of consistency in the care workers they saw. They stated that care workers did not have enough time to build meaningful relationships with them as they were too rushed to do so. Care records contained very limited details about people’s individual needs or preferences, but care workers demonstrated a good level of knowledge about people they saw regularly.

People we spoke with and their relatives told us they were involved in decisions about their care and how their needs were met.

Recruitment procedures ensured that suitably qualified and experienced staff were appointed to work within the service. There was a suitable induction programme for new staff along with ongoing training. However, care staff did not receive regular supervisions, spot checks or appraisals of their performance.

The provider appropriately conducted investigations into complaints and incidents that occurred during the delivery of care.

Information was reported to the CQC as required. Care staff gave good feedback about the managers of the service and confirmed they were they were approachable.

During this inspection we found breaches of regulations in relation to safe care and treatment, meeting people’s nutritional needs, personal care and good governance. You can see what action we told the provider to take at the back of the full version of the report.

This service is a domiciliary care agency. It provides personal care for people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of the inspection they were supporting 158 people in the London Boroughs of Croydon and Lambeth. Not everyone using Beverley Martins receives a regulated activity; 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.

Prior to our inspection we received some information of concern from an anonymous source. The information indicated potential concerns about the completion of care plans and risk assessments, staff pre-employment checks and the management of medicines. Further concerns were raised about staff training, staff behaviour towards people, complaints management, record keeping and the manager’s lack of response to care worker’s concerns. We looked into these concerns during this inspection.

At the time of our inspection there was no registered manager at the service. 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. The previous manager had recently left the service and a new manager had been appointed and was working at the service when we visited. They had submitted their application to be the registered manager to the CQC.

Risk assessments and support plans contained some information for staff, but did not contain a sufficient level of detail about how care workers were expected to mitigate known risks. We therefore could not be assured that people were protected from avoidable harm.

Staff demonstrated an understanding of people’s life histories and current circumstances and supported people to meet their individual needs. Care records included some information about activities people attended, where this was part of their package of care. However, care records contained very limited details about people’s recreational interests where people received a ‘sitting’ service.

The service ensured people's privacy and dignity was respected and promoted.

People were supported with their nutritional needs where this formed part of their package of care. However, care records contained very limited information about people’s dietary needs.

The provider’s governance framework ensured responsibilities were clear. However, whilst quality performance, risks and regulatory requirements were understood, these were not always effectively managed.

Safeguarding adults from abuse procedures were in place and care workers understood how to safeguard people they supported. Care workers had received safeguarding adults training and were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.

Staff demonstrated knowledge of their responsibilities under the Mental Capacity Act 2005 (MCA). Care records contained details of people’s capacity and were signed by people using the service or those lawfully acting on their behalf.

People we spoke with and their relatives told us they were involved in decisions about their care and how their needs were met.

Recruitment procedures were thorough and ensured that only staff who were suitable worked within the service. The service also ensured there were sufficient numbers of suitable staff to support people.

Complaints were investigated and responded to in a timely manner.

Staff had the skills, knowledge and experience to deliver effective care and support, and received support for their roles. There was an induction programme for new staff which prepared them for their role.

The provider had a clear vision and credible strategy to deliver high-quality care and support. Staff demonstrated that they were clear about the values of the organisation and said these guided their work.

During this inspection we found two breaches of regulations in relation to safe care and treatment and good governance. You can see what action we told the provider to take at the back of the full version of the report. We also made a recommendation about developing person centred care plans.

The service had a registered manager 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.

People receiving the service felt safe. Staff understood how to keep people safe from abuse. Staff had safeguarding training and could recognise signs of abuse and knew what actions to take if they suspected it.

People were protected from avoidable harm because risks to their health and wellbeing were assessed and plans developed to manage risks. People were protected from unsuitable staff by a robust recruitment process. People had their medicines managed safely and received them as prescribed.

People received effective care and support from trained and supervised staff. People’s consent was sought and their rights were upheld in line with legislation. Staff supported people to access healthcare resources as their needs required and their nutritional and hydration needs were assessed and met.

Staff were compassionate, supported people to make informed decisions and showed people dignity and respect.

People’s care records reflected their assessed needs and were reviewed when their needs changed. People’s cultural needs were supported. The provider sought people’s views about the care and support they received and people felt listened to. People knew how to complain and the provider addressed complaints appropriately.

The manager demonstrated an open management style and staff felt supported. The quality of care being delivered to people was audited. There were systems in place to monitor, review, and make improvements to the service.

The provider had systems in place to gain consent from people before providing care. We found care plans and risk assessments in people's records. One staff member said, 'I always communicate and listen to their preferences before providing care.'

The provider had an infection control policy and we found a staff training programme was in place. Staff had access to personal protective equipment such as disposable gloves and aprons and all the people and relatives we spoke with told us staff used these when providing personal care.

The provider had a complaints policy in place and people were supported to give feedback on the service they received through regular quality reviews and an annual survey. One person told us that when they had raised a concern it had been responded to and dealt with.

We found the agency had a recruitment and selection policy. The provider had systems in place which ensured staff had the right skills and experience to meet the needs of people they cared for.

Staff and people using the service told us that they were involved in choosing how and when their care was provided and how they wanted things done.

People were happy and satisfied with the service and the carers. People we spoke with told us, 'My carer's so nice, so obliging, out of this world' something a little extra', 'My carer gets everything I need done', and another person said 'They do their best, they're cheerful and helpful.'

People's needs were assessed and care was planned and delivered in line with their individual care plan. Care plans contained clear information about how the person preferred to be cared for. The care plans had been reviewed and updated on a regular basis, to ensure they still met people's needs and preferences.

People felt that they had choice and control in how their needs were met, and did not ever feel taken advantage of by anyone in the service. They told us that if they had any problems with staff or the delivery of their service they would talk to the manager, one of the directors or with the council. However, no-one had needed to do so recently. One person said, 'Everything's going like clockwork. I've no complaints'.