Vibrant Home Care

Vibrant Home Care is a domiciliary care agency providing personal care to people living in their own homes. The service provides support to older people and people who are nearing the end of their lives. At the time of our inspection there were 17 people using the service.

Not everyone who used the service received 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

Quality assurance processes did not always provide effective management oversight for some aspects of the service. Some audits were vague and did not include documented observations as requested on the audit template, such as observations of hand hygiene. There was a lack of oversight to accidents, incidents, and complaints to establish and address emerging trends.

People’s health risks were not always fully assessed. Risk assessments were not always completed, 2 people’s risk assessment for moving and positioning had not been entirely completed. Care plans for people who required support with their skin integrity did not always contain important information. Other risk assessments, such as, for the use of catheters and equipment to support safe nutrition was detailed and contained enough information for staff.

People were not always protected from infectious diseases by good staff practices, we received some feedback that staff did not always keep people’s homes tidy. People were kept safe by staff who understood their responsibilities to recognise and report safeguarding concerns. People received their medicines safely; staff were trained and assessed as competent before administering people’s medicines.

People were supported by care staff who received training relevant to their role. Newly recruited staff completed an induction course which included shadowing a more experienced staff member. Where people’s needs changed, the registered manager sourced training for staff to be able to safely support them.

People told us there were enough staff to support them, where people required 2 staff, this was planned for and met. People and their relatives spoke highly of the care staff. A relative said, “Staff are brilliant at making sure privacy is respected.” A person told us, “The staff are fabulously caring.”

People and their relatives told us they were comfortable to complain. A person said, “I’m quite happy to contact the office if I need to. We did have some teething problems at the start.” We were given some examples of complaints raised by people and their relatives, they confirmed they were satisfied with the outcome. These complaints had not been included in the complaints log, which meant the registered manager was unable to ascertain and address reoccurring trends of complaints.

Staff worked with health and social care professionals to ensure people’s needs were met. Care records confirmed where staff had contacted district nurses to escalate concerns about people’s health. The registered manager described a good working relationship with the local hospice to ensure people had everything they needed to remain comfortable when at the later stages of their lives.

People were supported to have maximum choice and control of their lives and staff supported them 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 13 March 2023).

Why we inspected

This inspection was prompted by a review of the information we held about the provider and concerns in respect of their practice.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive, and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Vibrant Home Care on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to assessing risks, quality assurance processes and management oversight.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Vibrant Homecare - Ashford is a domiciliary care agency providing the regulated activity of personal care. The service provides support to people with physical disabilities and dementia. At the time of our inspection there were 6 people using the service.

Not everyone who used the service received 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 and their relatives met with senior staff regularly to review their care and support needs. However, two relatives told us that management were not always forthcoming when people requested changes to their care packages. This was an area for improvement.

There was a lack of information about how people wished to be supported at the end of their lives. This was an area of improvement.

People were safe. Staff had the training and knowledge to identify signs of abuse and escalate concerns as and when required. Risks to people were identified and mitigated. The provider carried out the necessary checks on new staff to ensure they were safe to work with people. People’s nutritional and hydration needs were met and infection control measures reduced the risk of spread of infection. Incidents and accidents were investigated and lessons learnt.

People’s needs were assessed so staff knew how to support them. Best practice tools were used to monitor people’s health. Staff identified when people were unwell or needed additional support and referrals were made to medical professionals as required. Staff had regular training, online and in-person and regular supervisions with management. Ad hoc spot checks and competency assessments took place to monitor staff’s performance. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated with kindness, dignity and compassion. People and staff spoke fondly of one another. Staff took the time to get to know people and encouraged them to maintain their hobbies and interests. People’s communication needs were understood, and people told us that they felt comfortable and confident expressing their views and sharing any concerns with staff.

People felt comfortable raising complaints, and these were properly investigated by the registered manager, who demonstrated understanding of duty of candour.

The service was well-led. The provider had oversight of the service and the care and support needs of the people they support. Staff felt supported by management and there was an open-door policy. Audits were carried out on a regular basis by senior staff, the registered manager and provider. Checks and audits identified shortfalls which were then rectified. The provider was part of the Skills for Care network which shared the latest and best practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and a negative culture within the service. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, effective, caring, responsive and well-led sections of this full report.

We will continue to monitor information we receive about the service, which will help inform when we next inspect.