The Business Centre

The Business Centre is a domiciliary care agency which provides personal care to people in their own homes. The service provides support to older people and younger adults with a range of needs including people with physical disabilities. At the time of our inspection the service was providing the regulated activity personal care to 50 people. Not everyone who used the service received personal care. 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.

People’s experience of using this service and what we found

Quality monitoring and checks had not always been completed to provide effective managerial oversight of the service. The provider acknowledged improvements were needed to fully embed the governance systems they had developed.

Some people told us their call times could be better managed. They didn’t always know when staff would arrive for their care appointment. Medicines were administered safely by staff trained in medicines management.

Risks to people were being managed safely. We found risk assessments had improved since the last inspection and staff were recruited safely. Staff received training and felt supported by the management team.

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

The last rating for this service was Requires Improvement (published 30 September 2022) and there was a breach of regulation 19. 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 this regulation.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service and what we found

Staff were not always recruited safely in line with the providers policies and risks associated with people’s health needs were not always clearly documented. Despite, these shortfalls people felt safe with staff. The registered manager told us they would take action, to address these issues.

Some people told us their call times could be better managed, stating they didn’t know when to expect staff to arrive at their homes. Medicines were administered safely, by staff trained in medicines management.

Quality assurance checks were not always effective, as they had failed to identify the issues we found. The provider had a contingency plan in place, to minimise any risks to the service running safely in the event of, for example adverse weather conditions. Staff felt supported by the management team.

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

The last rating for this service was good (published 26 October 2018).

Why we inspected

We received concerns in relation to the recruitment of staff to the service. As a result, we undertook a focused inspection to review the key questions safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Business Centre on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We identified a breach in relation to the recruitment of staff.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

G4 Enterprise House is registered to provide personal care to people in their own homes and was registered with us in March 2017. This was the first inspection of this service following registration with us. At the time of this inspection, the service was providing personal care to ten people.

There was a registered manager in place. 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. Both the registered manager and provider were managing the service and are referred to as ‘the management team’ in the inspection report.

People received care from a consistent staff team who arrived when they were expected and stayed the allocated time. People felt safe with staff because they had been trained to provide effective care that met their individual needs and preferences. The provider had a recruitment system which included a number of pre-employment checks to ensure staff were suitable to work with people.

People’s needs were assessed before they received a service so that any potential risks to providing their care and support could be identified and minimised. Care plans contained instructions for staff to follow to ensure people’s care needs were met consistently. Staff understood how to support people safely and to report any concerns about people’s health and wellbeing to the management team.

People were fully involved in planning and reviewing their care and any likes, dislikes and preferences had been recorded in care plans to ensure people received person centred care. People were supported with food and drink when needed.

Staff sought consent from people before each care intervention and understood the importance of supporting people’s independences and wishes.

People were treated with care and kindness by staff who took time to get to know them and understand their needs. Staff had received training in equality and diversity and treated people with respect. People told us staff communicated effectively with them to ensure their wellbeing.

People were given a ‘handbook’ which contained details of the providers’ complaints procedure if they should need it and people knew who to approach with any concerns.

Staff spoke positively of the management team and told us they felt supported to carry out their role, including out of hours, when needed. However, whilst there was governance and accountability arrangements in place, as the service was quite new, systems and processes were still being embedded. We found records were not always sufficiently detailed to demonstrate effective processes were in place to support people’s needs and monitor the quality of service.