Archived: Better Healthcare Services (Brighton)

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.

Better Healthcare Services (Brighton) is a domiciliary care agency. It provides personal care to people living in their own homes in the community and provides a service to adults. On the day of the inspection the service was supporting approximately 140 people with a range of health and social care needs, such as people with a physical disability, mental health issues, sensory impairment or people living with dementia. Support was tailored according to people’s assessed needs within the context of people’s individual preferences and lifestyles to help people to live and maintain independent lives and remain in their homes. Not everyone using Better Healthcare Services (Brighton) receives 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.

This service was registered by CQC on 13 September 2017, due to a change in the legal entity, however the management and staff remain the same as the previous registration. Better Healthcare Services (Brighton) has not been previously inspected under their current registration.

The service had a registered manager. 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.

Outstanding, person centred and innovative training resources equipped staff with the skills, knowledge and understanding to meet the challenges of supporting people with diverse and complex needs. Bespoke training had been developed to ensure that people remained safe and had their health and wellbeing protected at all times. This increased the overall skills of the staff team which complemented the delivery of high quality care. There was a culture of embracing learning and development within the service. People and their relatives felt confident in the skills of the staff and they received effective care that met their needs.

Sufficient staff were available to ensure people's wellbeing and safety was protected. A robust recruitment and selection process was also in place.

Staff had a good understanding of systems in place to manage medicines. People were supported to receive their medicines safely. Staff considered people’s capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were kind and caring and had developed good relationships with people. People told us they were comfortable in the presence of staff. They confirmed the staff were caring and looked after them well. People were provided with the care, support and equipment they needed to stay independent in their homes.

People were provided with information and guidance to access other services which were relevant to them for any on-going support. People’s individual needs were assessed and detailed care plans were developed to identify what care and support they required. People were consulted about their care to ensure wishes and preferences were met.

Quality assurance and information governance systems were in place to monitor the quality and safety of the service. People and relatives all told us that they were happy with the service provided and the way it was managed. Social activities and events were planned and the provider regularly supported charity events and raised money for these events.

Further information is in the detailed findings below.