Beyond Support Limited

Beyond Support Ltd is a domiciliary care agency which provides personal care to people in their own homes. At the time of our inspection the service was providing the regulated activity personal care to 18 people. CQC only inspects the service being received by people provided with 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

Risks associated with people’s care were assessed and staff understood their responsibilities to keep people safe. However, some care records required further information to provide staff with clearer guidance on how to support people safely.

Some people told us their call times could be better managed, stating they would like a smaller time frame of when to expect staff. People told us they felt safe and had confidence in the staff that supported them. Staff were recruited safely, and medicines were administered as prescribed, by staff trained in medicine management.

Management oversight of the service had improved since our last inspection. A range of quality monitoring systems and processes had been introduced. However, further time was needed for these to fully embed and ensure improvements made were sustained. The provider had a contingency plan in place, to minimise any risks to the service running safely in the event of, for example, adverse weather conditions. Staff felt supported by the management team.

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 requires improvement (published 21 November 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Beyond Support Ltd is a domiciliary care agency providing personal care to seven people in their own homes.

People’s experience of using this service and what we found

The registered provider’s system for reviewing people’s care had not demonstrated complete oversight of the care people received. The provider systems had not identified people’s medication records had not been completed accurately and no action had been taken to address this. There were no systems in place for an effective oversight of training. The provider told us they had a good knowledge of people’s care needs, however this had not been recorded.

People told us they felt safe in their homes with staff they were familiar with and who had been introduced to them. Risks to people’s health were known by staff but it was not always clear what action needed to be taken by staff. Staff recruitment was ongoing and the registered provider had a process in place to recruit people safely. Staff understood how to prevent the spread of infection by using protective clothing such as aprons and gloves.

People were involved in planning and updating their care needs. People felt consulted and listened to about how their care would be delivered. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The service worked in partnership with healthcare professionals and families to ensure people's health care needs were met. Where appropriate, people chose their meals and staff helped prepare drinks.

People’s end of life wishes were known to staff who worked with families to ensure people’s needs were met.

People understood how to complaint and told us they regularly spoke with the registered provider.

Rating at last inspection: The last rating for this service was requires improvement (published 13 February 2019).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. There was a breach of Regulation 19 Fit and proper persons employed of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.. This breach has now been removed.

Why we inspected

The inspection was prompted in part due to concerns received about staffing and recruitment processes. 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 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.

About the service:

This service is a domiciliary care agency which provides personal care to people living in their own homes. At the time of our visit 10 people were being supported with personal care.

People’s experience of using this service:

We looked at the recruitment of two members of staff and found appropriate checks had not been followed. This included a Disclosure and Barring Service check (DBS), references and a full employment history on their application form. There was no evidence this had been discussed at interview or a satisfactory written explanation sought.

People told us they felt safe with the support they received from the staff. People told us they were supported by staff who knew and consistently met their needs. Staffing levels were continuously reviewed to ensure there were enough staff to provide a flexible and responsive care. However, people supported by the service told us they would like a copy of the staff rota so they would know which staff were scheduled to visit. We have made a recommendation about this.

People’s care and support had been planned proactively and in partnership with them. People felt consulted and listened to about how their care would be delivered. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

The service worked in partnership with healthcare professionals and families to ensure people’s health care needs were met. Care plan information focused on a person-centred method of supporting people. Also, information contained what support was required. We discussed with the registered provider to ensure end of life care planning documentation was more prominent in care records. This was to guide staff on the preferred arrangements for end of life for each person. We have made a recommendation about this.

People supported by the service and their relatives consistently told us the registered manager and staff who supported them were polite, reliable, caring and professional in their approach to their work. They spoke positively about the quality of service provided.

There had not been any safeguarding incidents or complaints since the service was registered. However, policies and procedures were in place and the registered provider understood the actions to take should there be any incidents.

The registered provider used a variety of methods to assess and monitor the quality of the service. This enabled the service to be monitored and improve areas that were identified through their quality monitoring processes.

More information is in the detailed findings below.

Rating at last inspection:

This was the first planned inspection of the service since its registration with CQC on 24 August 2017.

Why we inspected:

This was a planned and scheduled inspection.

Enforcement:

Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up:

We have requested an action plan from the registered provider as to how they plan to address the breach in regulation and make improvements to the service.

The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service. We may inspect sooner if we receive concerning information about the service.