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Inspection Summary

Overall summary & rating


Updated 4 January 2018

This inspection took place on 29 November 2017. The inspection was announced. We gave the provider two days’ notice of our inspection. This was to make sure we could meet with the manager of the service and talk with staff on the day of our inspection visit.

Bella Home Care is a domiciliary care agency, registered to provide personal care and support to people living in their own homes. The service operates across Leamington Spa, Warwick and Kenilworth. The service provides care to elderly people, and people with disabilities. There were125 people using the service at the time of our inspection.

We previously carried out an announced comprehensive inspection of this service in September 2016 when we found two breaches of the legal requirements and the service was rated Requires Improvement overall. We returned in April 2017, when we conducted a focussed inspection in the key areas of Safe and Well-led to check what action the provider had taken in respect of the breaches. At that inspection we found the provider had taken sufficient action to meet the regulations but further improvements were still required to ensure people always received their scheduled calls. The service therefore remained rated as ‘Requires Improvement’ overall. You can read the report from our last two inspections by selecting the ‘all reports’ link for ‘Bella Home Care’ on our website at

Since our inspection in April 2017 we have reviewed and refined our assessment framework, which was published in October 2017. Under the new framework certain key areas have moved, such as support for people when behaviour challenges, which has moved from Effective to Safe. Therefore, for this inspection, we have inspected all key questions under the new framework, and also reviewed the previous key questions to make sure all areas were inspected to validate the ratings.

The service is required to have 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 and associated Regulations about how the service is run. At the time of our inspection there was an experienced registered manager in post. We refer to the registered manager as the manager in the body of this report.

On this inspection visit we found sufficient improvements had been sustained to people’s care and safety and in the governance of the service for the provider to meet the regulations, and for the service to be rated Good in all areas.

Staffing levels had been increased and people told us they received their calls on time. All necessary checks had been completed before new staff started work to make sure, as far as was possible, they were safe to work with the people in their own homes. People were supported by a staff team that knew them well, as the provider did not use temporary staff.

Staff received training and had their practice observed to ensure they had the necessary skills to support people. Staff treated people with respect and dignity, and supported people to maintain their privacy and independence.

People had been consulted about their wishes at the end of their life. Plans showed people’s wishes about the medical interventions they had agreed to.

People received their medicines as prescribed to maintain their health and wellbeing. People were supported to access healthcare from a range of professionals, and received support with their nutritional needs. This assisted them to maintain their health.

People told us they felt safe with the staff who supported them and that staff were kind and attentive to their needs. Prior to using the service people were assessed to ensure the service could meet their needs and people told us they felt involved in decision-making about their care and support.

Staff enjoyed working

Inspection areas



Updated 4 January 2018

The service was safe.

People told us there were enough staff to meet their needs. People received their medicines as prescribed. Risk assessments and risk mitigation plans were in place to minimise the risks associated with people�s care. People told us they felt safe when receiving care and support. Staff knew how to raise concerns and safeguard people from potential harm.



Updated 4 January 2018

The service was effective.

Staff completed induction and training so they had the skills they needed to effectively meet people�s needs. Where people could not make decisions for themselves, people�s rights were protected; important decisions were made in their �best interests� in consultation with health professionals. People were supported to see healthcare professionals when needed. People received food and drink that met their preferences and supported them to maintain their health.



Updated 4 January 2018

The service was caring.

Staff knew people well and respected people�s privacy and dignity. Staff treated people with care and kindness.



Updated 4 January 2018

The service was responsive.

People had personalised records of their care needs and how these should be met. People were able to raise complaints and provide feedback about the service. Complaints were analysed to identify any trends and patterns, so action could be taken to make improvements. End of life care planning involved people in decisions that took into account their wishes and preferences.



Updated 4 January 2018

The service was well-led.

The provider had ensured that effective quality assurance procedures were in place to assess and monitor the quality and safety of the service people received. Staff felt supported by the management team. People told us they were asked for their feedback on how the service could improve.