Archived: Braeburn Care (Sevenoaks)

Updated 31 October 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 is 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.

The inspection site visit activity started on 07 August 2018 and ended on 30 August 2018. The inspection was announced. We gave the service 48 hours’ notice of the inspection visit because the location was a small care service and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. The inspection was carried out by one inspector. The inspection included visiting people in their homes, shadowing staff providing care, talking with relatives and phone calls to people and their relatives. We visited the office location on 15 August 2018 to see the registered manager and office staff; and to review care records and policies and procedures.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed notifications that the management team had sent. A notification is information about important events which the service is required to send us by law.

We observed staff interactions with four people and observed care and support in communal areas. We spoke with eight people who received care and support and three relatives. We spoke with six staff, which included care staff, a field care supervisor, the registered manager and the provider’s nominated individual who was one of the company directors.

We requested information by email from local authority care managers, occupational therapists and commissioners who are health and social care professionals involved in the service. We also contacted Healthwatch to obtain feedback about their experience of the service. There is a local Healthwatch in every area of England. They are independent organisations who listen to people’s views and share them with those with the power to make local services better.

We looked at the provider’s records. These included five people’s care records, which included care plans, health records, risk assessments, daily care records and medicines records. We looked at three staff files, a sample of audits, satisfaction surveys, staff rotas, and policies and procedures.

We asked the registered manager to send additional information after the inspection visit, including staff training records, policies and additional staff recruitment records. The information we requested was sent to us in a timely manner.

The service had been registered with us since 08 August 2017. This was the first inspection carried out on the service to check that it was safe, effective, caring, responsive and well led.

Updated 31 October 2018

This inspection took place on 07 August 2018, the inspection was announced.

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 people living with dementia, older people, people with learning disabilities and autistic spectrum disorder, people with a mental illness and people who have a physical disability.

Not everyone using Braeburn Care (Sevenoaks) 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. There were 39 people receiving support with their personal care when we inspected.

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 to people's safety and welfare had not always been well managed to make sure they were protected from harm. The management team took immediate action to address this. We made a recommendation about this.

The provider had followed effective recruitment procedures to check that potential staff employed were of good character and had the skills and experience needed to carry out their roles. Staff had attended training relevant to people's needs. They were provided with one to one supervision meetings and regular spot checks to ensure that they were putting their training into practice.

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.

Effective systems were in place to enable the provider to assess, monitor and improve the quality and safety of the service. The service worked in partnership with health and social care professionals to ensure people received joined up care. People had opportunities to feedback about the service they received.

People were supported and helped to maintain their health and to access health services. Timely action had been taken when people's health needs changed.

Medicines were well managed. Staff had received medicines training. Medicines had been recorded adequately and medicines records were audited regularly.

People's care plans were clear for staff about how they should meet people’s care and support needs.

Essential information about people such as their life history, likes, dislikes and preferences were included. Care plans had been reviewed and amended regularly to ensure they reflected each person's current need or specific healthcare needs.

People knew who to complain to if they needed to. The complaints procedure was available in the office and people had copies within their handbooks in their homes. Complaints had been handled effectively, the provider had made improvements as a result of complaints.

People were protected from abuse or the risk of abuse. The registered manager and staff were aware of their roles and responsibilities in relation to safeguarding people.

Some people received support to prepare and cook meals and drinks to meet their nutritional and hydration needs.

There were suitable numbers of staff on shift to meet people's needs. People received consistent support from staff they knew well.

People's information was treated confidentially. People's records were stored electronically and were accessed by staff who had been allocated passwords.

People and relatives told us that staff were kind and caring. Staff treated people with dignity and respect.

People were supported at the end of their life to have a comfortable, dignified and pain free death. Staff were respectful, gentle and kind and did all they could to ensure people were not in pain.

Staff were positive about the support they received from the management team. They felt they could raise concerns and they would be listened to.

Staff used personal protective equipment to safeguard themselves and people from the risks of infection.