13 June 2018
During a routine inspection
This inspection took place on 13 and 14 June 2018 and was announced. It was the first inspection of this service under their new provider registration.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and people living with physical disabilities. Some people were living with dementia.
Not everyone using Beech Tree Total Care receives 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.
There was 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.
Risks relating to people’s care and support had been assessed and mitigated where possible. People were protected from the spread of infection, and staff had access to protective equipment such as gloves and aprons. When accidents or incidents occurred these were recorded, collated and analysed to look for trends and patterns and ways of reducing the chances of them occurring again. Staff knew how to recognise and respond to abuse, and the registered manager had reported any safeguarding concerns to the local authority.
The registered manager monitored staffing levels to ensure there were enough staff to provide people the necessary support. People told us that staff were usually on time, and stayed the entire duration of their call. Staff were recruited safely.
Staff received the training they needed to provide effective support. The training manager had been nominated for a national award, in recognition for their work. The service regularly supported people at the end of their lives, and staff had received specialist training to enable them to do so.
Senior staff completed regular spot checks on staff, to ensure they were carrying out their roles competently and staff had regular opportunities to reflect on their practice.
People received support to eat and drink safely. When we visited people in their homes staff had left out a selection of hot and cold drinks for people to enjoy throughout the day. Staff sought advice from a range of healthcare professionals when people’s needs changed, and contacted people’s doctors if they became unwell. Medicines were managed safely and people were supported to lead healthier lives.
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 were supported to be as independent as possible. Staff had an understanding of people’s equality and diversity needs and told us they would challenge discrimination in any form.
People and their relatives told us that staff were kind and caring. Staff had regular people they visited, and people told us they had built up strong relationships with the staff that supported them. Staff treated people with respect and dignity.
People had been involved in planning their care; they told us about when staff had visited them for their initial assessment and at regular review meetings. A range of recognised tools, such as Waterlow scores, to assess the risk of people’s skin breaking down, had been used as part of the assessment process.
Staff, people and their relatives all told us that the service was well-led. The registered manager was skilled and experienced in providing domiciliary care. Their work has been recognised formally at ‘The Great British Care Awards.’ There was an open culture and staff told us they were well supported by the management team. The registered manager and senior staff worked in partnership with a range of organisations to share best practice and drive improvements within the sector.
Senior staff completed a range of checks and audits to ensure the service was compliant with the fundamental standards and regulations. The registered manager had notified us of any important events that had happened within the service. People were provided with information regarding how to complain and regular feedback was sought from people, their relatives and staff. This was analysed and used to make improvements within the service.