Background to this inspection
Updated
17 March 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 was planned to check whether the provider was 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 was a comprehensive inspection, which took place on 5 March 2018 and was announced. The provider was given 48 hours' notice of our visit because we wanted to ensure the registered manager was available to support the inspection.
The inspection team consisted of one inspector and two experts by experience, who made telephone calls to people receiving a service in their own home. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection we reviewed the evidence we had about the service. This included any notifications of significant events, such as serious injuries or safeguarding referrals. Notifications are information about important events which the provider is required to send us by law.
During our inspection we visited the agency's office and spoke with the provider, the personal assistant to the provider, two field care supervisors, one team leader, one care co-ordinator and we spoke on the telephone with five staff who worked in the community. The experts by experience spoke with ten people that used the service and twelve relatives of people that used the service.
We looked at the provider’s records. These included people’s care records seen on the newly implemented electronic system, which included care plans, health records, risk assessments and daily care records. We also looked at medicines administration records. We looked at staff recruitment files, a sample of audits, staff rotas, staff meeting minutes and staff training records.
This was the first inspection of the service following a move to new office premises.
Updated
17 March 2018
We inspected Braeburn Care (Tunbridge Wells and Tonbridge) on the 5 March 2018. The inspection was announced. Braeburn Care is a domiciliary care agency based in an office in Tonbridge, registered to provide personal care for people who require support in their own home. The organisation is registered to provide care. At the time of our inspection Braeburn Care were providing care to approximately 120 people who had a range of needs from old age, dementia and mental health. The service employed over 40 staff members.
When we completed our previous inspection on 12 February 2017, at the previous office address of the service, we identified two breaches of the legal requirements set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 12, (Safe Care and Treatment) as medicines were not consistently managed in a way which ensured people received them in a safe and effective manner with regard for the risks associated with them; Regulation 17, (Good Governance), the provider had failed to operate a robust quality assurance framework. We also made three recommendations for good practice, that; the provider sought guidance from a national source on robust risk assessments; the provider sought guidance on how to implement the MCA 2005 Code of Practice and the provider sought guidance from a national source about the implementation of a person centred care plans.
At this inspection we found that improvements had been made to all identified areas.
Medicines were managed safely and people received them as prescribed. People were supported with medicine management when needed and care workers had received training on how to administer medicines.
Systems were in place to enable the provider to assess, monitor and improve the quality and safety of the service and these were being followed. An electronic system to monitor if staff were staying the allocated times at care calls was now effective.
Individual risk assessments were in place which considered for example, moving and handling, falls and skin integrity. Systems were in place to monitor accidents and incidents.
The provider had appropriately implemented the Mental Capacity Act (2005) Code of Practice. Training schedules confirmed care workers had received training on the Mental Capacity Act (2005). Staff told us how they gained consent from people before delivering care. Consent forms were in place for people to sign to indicate their consent to the package of care and care plan.
Person centred care plans had been put in place when implementing the new electronic system of recording records. People had individual care plans and staff spoke highly of these. Information was available on the person’s personal history and hobbies and interests.
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. The registered manager was unavailable on the day of the inspection, and the provider and management team supported the inspection process.
People who received personal care and support from Braeburn Care told us they were happy with the service provided. One person told us, “They (staff) are very good. I cannot complain about anything”. Staff treated people with kindness and respect for their privacy and dignity. Staff knew people well and remembered the things that were important to them so that they received person-centred care. One person told us, “I would recommend Braeburn to anyone. They do not take liberties. They are respectful”.
People receiving support felt safe and well cared for. They were protected from harm because care workers understood the risks they faced and how to reduce these risks. They also knew how to identify and respond to abuse. Staff were vigilant of people’s health care needs and ensured they had access to health care professionals to maintain their health. Staff understood the need to share information about changes in people's health. People were supported to eat and drink enough to meet their needs.
There were enough safely recruited care workers to ensure the care could be provided. Staff told us told us they felt supported in their roles and had received training that provided them with the necessary knowledge and skills to do their job effectively.
People were supported by staff who were passionate about their work. Staff told us they liked working for the organisation and appreciated that the organisation put people first.
People and relatives told us they felt able to raise any concerns with the registered manager. They felt these would be listened to and responded to effectively and in a timely way. The provider ensured the complaints procedure was made available in an accessible format if people wished to make a complaint. Regular checks and reviews of the service continued to be made to ensure people experienced good quality safe care and support.
The provider provided good leadership. They checked staff were focused on people experiencing good quality care and support. Staff told us the management team were approachable and responsive to their ideas and suggestions.