Background to this inspection
Updated
4 March 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was conducted by three inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had two managers registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 8 November 2021 and ended on 22 November 2021. We visited the registered office in Weston-Super-Mare on 8 November 2021. We visited an office site in Northampton on 15 and 16 November 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from external sources. The provider was not asked to complete a provider information return prior to this inspection. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.
During the inspection
The provider was not operating from their registered location in Weston-Super-Mare. Therefore, we visited an unregistered office site in Northampton to ensure the provider had every opportunity to fully participate in the inspection.
We reviewed all information that was present. This included information relating to recruitment induction, training and supervision. We also looked at records relating to the management of the
service such as governance systems, meeting minutes, policies and the management of safeguarding.
We were obstructed from viewing information in relation to staff worked hours and the management of payroll. There were no archived records available.
We spoke with three staff members and the registered managers. We visited three people who received care and support and spoke to two relatives.
After the inspection
We continued to validate evidence found. We reviewed all recruitment information.
Updated
4 March 2022
About the service
Bright Care Agency is a domiciliary care agency providing personal care to people in their own homes. The service is registered in Weston-Super-Mare, North Somerset. However, at the time of the inspection, the service was operating from premises in Northampton. This was not a registered location. Bright Care Agency was providing care to people who lived in the Northampton area.
As a result of concerns identified at our previous inspection in October 2020, we imposed conditions on the provider’s registration. Conditions are used to limit, or restrict, what a provider can do. One of the conditions placed on the provider’s registration meant the service should only be providing a regulated activity to one person. However, we found a further two people were receiving a service from Bright Care Agency. This meant the provider was not working in accordance with the conditions placed on their registration.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to 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
People received poor quality care as there was widespread and significant failings across all aspects of the service. Bright Care Agency was not well-led and managed. There was a lack of oversight and governance. This put people's safety at risk and did not ensure people received a caring service. The registered managers had failed to address any previous shortfalls, resulting in a lack of improvement.
The registered managers did not follow safe recruitment procedures. Risks to people were not identified and risk guidance was not in place in people's care records. Systems to monitor and administer medicines had not improved. Infection control risks were not mitigated. Staff were not being regularly tested for COVID-19 in line with guidance. People were not safeguarded from potential abuse and neglect.
Staff did not receive a sufficient induction or consistent supervision to enable good quality care practices to develop. Staff had completed training. However, this was not always received before delivering care or in line with published guidance.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice
People did not always receive a caring and person-centred experience. We received mixed feedback about how staff cared for people. Care records did not always contain full information around communication, equality characteristics and people’s interests. People did not always have a care plan.
Complaints were not identified or responded to. The provider had failed to display their current CQC performance assessment. Notifications were not always submitted to CQC as required.
The provider had a disregard for legislation and guidance and had failed to adhere to the conditions on their registration. There was no required insurance in place which put people and staff at risk. Action had not been taken from previous inspections to progress and monitor improvements.
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 inadequate (published 30 November 2021) and there were multiple breaches of regulation. Following the inspection, CQC took enforcement action.
Why we inspected
This inspection was carried out to check, if improvements had been made and the provider was working in accordance with conditions placed on their registration.
We have not found any evidence the provider has made improvements.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bright Care Agency 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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We had identified seven repeated breaches of regulation and a further five breaches at this inspection. This demonstrated significant and widespread failings.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
At the last inspection it was recognised that the provider had failed to display their performance assessment rating and continued to do so after this was reported. This was a breach of regulation and we issued a fixed penalty notice in March 2021. The provider accepted a fixed penalty and paid this in full.
Follow up
We will continue to follow our enforcement procedures.
Special Measures
The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.