Better at Home (IOW) Limited

Better at Home (IOW) Limited is domiciliary care agency which provides support and personal care to people living in their own home. Not everyone using Better at Home (IOW) Limited 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 take into account any wider social care provided. At the time of our inspection 60 people were receiving a regulated activity from the service.

People’s experience of using this service:

We received positive feedback from all people and relatives. All staff including the management team, care staff and office staff were praised for their kindness and professionalism and the consistent high quality and reliability of the service provided.

People told us they received safe care and were confident that if they raised concerns, the management team would act promptly to address these.

People were supported by consistent and suitably trained staff.

People received their medicines as prescribed and infection control risks were managed effectively.

Individual and environmental risks were managed appropriately, and people were protected from avoidable harm.

People's rights to make their own decisions were respected. Staff supported people to make choices in line with legislation.

People were supported to access health and social care professionals if needed.

Care plans were detailed and person centred. People were involved in deciding how they wished to be supported and in reviewing their care plans when needed.

The management team kept in regular contact with people by visiting them in their homes, checking if they were happy with the service they received and if any changes were needed.

The management team were open and transparent. They understood their regulatory responsibilities.

A quality assurance system was in place to continually assess, monitor and improve the service.

The service worked well with other partners, organisations and commissioners.

The service met the characteristics of Good in all areas. More information is in the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection:

The service was last inspected in October 2016 where we undertook a full comprehensive inspection (report published November 2016). It was awarded a rating of Good.

Why we inspected:

This was a planned inspection based on the previous inspection rating.

Follow up:

There is no required follow up to this inspection. We will continue to monitor all information received about the service to understand any risks that may arise and to ensure the next inspection is scheduled accordingly.

The last inspection of the service took place in October 2015, where we identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We set a requirement notice in relation to the management of medicines, the failure to ensure staff received regular supervisions and the failure to ensure there was an effective quality assurance process in place. We asked the provider to write to us with an action plan on how they planned to take to ensure they became compliant with the regulations.

This inspection was carried out between 19 and 25 October 2016 and at the time of our visit the service was providing personal care to 70 people. During the inspection we found the provider had completed all the actions they told us they would take.

There was a registered manager in place at 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 2008 and associated Regulations about how the service is run.

There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner. However, the recruitment process was not robust and all appropriate checks were not always completed before staff were able to work independently. We have recommended that the provider seek advice and guidance on adopting the latest best practice in respect of a developing a safe and effective recruitment process.

Staff were aware of the risks relating to people and how to manage them. However, records did not always provide sufficient information to allow staff who did not know the person to manage the risks relating to their care.

People and their families told us they felt the service was safe. Staff and the registered manager had received safeguarding training and were able to explain the action they would take if they identified any concerns.

There were suitable systems in place to ensure the safe management of medicines, were administered by staff who had received appropriate training and assessments. Healthcare professionals such as, GPs and district nurses were involved in people’s care when necessary.

People were supported by staff who had received an induction into the service and appropriate training, professional development and supervision to enable them to meet people’s individual needs. Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect. People were supported to have enough to eat and drink.

There was an opportunity for people and their families to become involved in developing the service and they were encouraged to provide feedback on the service provided through spot checks, client reviews and a questionnaire.

People and their families told us they felt the service was well-led and were positive about the registered manager who understood the responsibilities of their role. The provider had arrangements in place to deal with any concerns or complaints.

Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the service. There were systems in place to monitor the quality and safety of the service provided.

People's care had been planned and care plans were in a clear format. Records of daily care provided showed people were cared for according to their care plan. People were satisfied with their care. One person said 'I have never had a problem with them; they're always lovely to me'.

Staff were supported by regular supervision and appropriate training. Records showed issues of concern were addressed and followed up by the manager or senior staff.

The service had a system in place to obtain feedback from people using the service and their relatives. Reviews were carried out regularly and these showed people were satisfied with the care they received.