Archived: Better Healthcare Services (Brighton)

Updated 22 July 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of one inspector, an assistant Inspector and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger adults with physical disabilities. 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.

The service had a manager registered with the Care Quality Commission (CQC). Registered manager’s and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. However, at the time of our inspection, the registered manager was not in day to day charge of the service. Interim management arrangements were in place.

Notice of inspection

The inspection was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.

What we did

On this occasion we did not ask the provider to send us the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as incidents and abuse. We used this information to plan our inspection.

During the inspection

We reviewed a range of records. This included three staff recruitment files, training records, accident and incident recording, and records relating to the scheduling of care calls and the management of the service. We also viewed a variety of policies and procedures and quality assurance processes developed and implemented by the provider. We reviewed four people’s care records. We spoke with 30 members of staff, including the provider, the interim manager, care managers, administrators and care staff. During our inspection we spoke with 25 people and 10 relatives over the telephone.

Updated 22 July 2021

About the service:

Better Healthcare Services (Brighton) is a domiciliary care agency. It provides personal care to approximately 220 people living in their own homes in the community. The service supports people living in East and West Sussex, as well as Brighton and Hove. Better Healthcare Services (Brighton) supports people with a range of health and social care needs, such as people with a physical disability, sensory impairment or people living with dementia.

People’s experience of using this service:

People we spoke with gave us mixed feedback in respect to the care they received. They felt they were treated with kindness by their care workers and they felt safe. However, they did not feel the care received met their needs and preferences. People’s care visits were often late or early, and on occasion cut short. Systems for scheduling care visits did not enable staff to routinely attend to people’s care calls on time and stay for the amount of time they were scheduled for. People’s assessed needs or preferences were not always met and they did not receive continuity of care.

We found issues with staffing levels, staff training and support, and the deployment of staff. People’s feedback was mixed in respect to feeling the service was well managed. Some people were happy with the care they received. However, others did not feel routinely involved in their care, or feel their concerns and issues were acted upon. Improvements were also required to staff training and support.

Systems were in place for the recording of incidents and accidents. However, there was no evidence that incidents and accidents were followed up, monitored and analysed over time to recognise any emerging trends and themes, or to identify how improvements to the service could be made.

The provider had systems of quality assurance to measure and monitor the standard of the service and drive improvement. However, these systems had not ensured the areas of improvement identified at this inspection had been acted upon and prevented.

The provider was aware of the issues we identified at this inspection and had started to implement improvements.

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 30 November 2018).

Why we inspected

We received concerns in relation to the service providing regular care calls that met people’s needs and preferences. There was also an increased level of safeguarding concerns and complaints being made about the service. As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the key question of caring. We therefore did not inspect this. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe, effective, 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.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.