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Bright Care Agency Requires improvement

Reports


Inspection carried out on 3 September 2019

During a routine inspection

About the service

Bright Care Agency is a domiciliary care agency providing personal care to 16 people in their own homes. Not everyone who uses this kind of service receive 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

People felt the service lacked organisation and improvements were required to the management of the service. People did not receive care from consistent carers and care was regularly untimely.

The management and oversight of the service was insufficient. The service had been reliant on the local authority for support and had been unable to identify the required actions of a good service. Management structures were weak and ineffective contingency plans were in place to ensure the running of the service in the event the nominated individual and registered manager were unavailable.

Quality assurance processes were ineffective. There were some auditing systems in place however they had failed to identify concerns with medication or the timings of people’s care.

Improvements were required to ensure the management team reflected on when key aspects of the service went wrong, to learn, and ensure repeated concerns did not reoccur. The culture within the service did not promote person centred care.

Medication systems were unclear and unsafe and required improvement. Medication administration records were inconsistently recorded and not reviewed in a timely way.

People’s risk assessments were insufficient. They were not always in place for people’s identified risks and those that were recorded were not adequately reviewed and updated at regular intervals.

The timing of people’s care required improvement. People told us care was regularly not at the time they expected it, and staff did not stay for the required length of time. People felt they were well treated but were unable to build relationships with staff as they did not have regular members of staff. People also told us of the difficulties they had when staff did not have a good understanding of the English language.

People’s care plans were not sufficiently updated, and complaints were not adequately investigated and resolved.

People were supported to have their care 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 good (published 25 February 2019).

Why we inspected

The inspection was prompted in part due to concerns received about the management of the service and the quality of the care people received. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the Safe, Caring, Responsive and Well-Led sections of this full report.

Enforcement

We have identified breaches in relation to the management and quality assurance procedures of the service. We also identified breaches in relation to the risk assessments of people, and how people’s medicines were managed.

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.

Inspection carried out on 14 December 2018

During a routine inspection

This inspection took place on 14, 17 and 19 December 2018 and it was announced.

This was the first comprehensive inspection carried out at Bright Care Agency since the provider registered with the Care Quality Commission (CQC) in June 2017.

Not everyone using Bright Care Agency received 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 consider any wider social care provided. At the time of the inspection the provider confirmed 14 people received the regulated activity ‘personal care’.

The provider was also the registered manager for the service. 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 and associated Regulations about how the service is run.

The provider had submitted notifications of other events and incidents in a timely way to the Care Quality Commission (CQC). However, the provider had moved to a new business and location address in September 2018 and had not notified CQC of the change of address. The Care Quality Commission (Registration) Regulations 2009, requires providers to notify CQC, of any changes to their registration. The failure to notify CQC of the change of address meant the provider was in breach of a condition of their registration.

People felt safe. Staff received safeguarding training to enable them to recognise the signs and symptoms of abuse and how to report abuse. Individualised risk management plans promoted people's safety. Staffing numbers were appropriate to keep people safe.

Safe recruitment practices were followed to ensure staff employed were suitable to work at the service. Medicines were managed safely and in line with best practice guidelines. Infection control procedures were followed to protect people from spread of infection risks.

People's diverse needs were identified at assessment, and the care and support was provided in line with their assessed needs. Staff received training based on best practice guidelines and received support and supervision to further develop their skills and knowledge.

People were supported to eat and drink sufficient amounts; to access health support services and attend health appointments as and when required.

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's choices were respected, and their privacy and dignity was maintained. Staff provided support in a caring and supportive way. People were involved in the planning of their care which was person centred.

People were supported to raise any concerns or complaints about the service.

Governance systems were used to oversee, improve and drive continuous improvement across the service.