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Inspection Summary

Overall summary & rating


Updated 27 February 2018

The inspection was announced and took place on 15 January 2018.

BB Healthcare is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides personal care to people with a variety of needs including older people, younger adults, people with a learning disability, physical disability and people who need support with their mental health.

Not everyone using BB Healthcare 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. When we inspected, 46 people were being provided with ‘personal care’.

At our last comprehensive inspection on 13 September 2016, the overall rating of the service was, ‘Requires Improvement’. This summary rating was the result of us rating the key questions ‘safe’, ‘effective’, ‘responsive’ and 'well-led' as, ‘Requires Improvement’. We asked the provider to complete an action plan to show what they would do and by when to improve the key questions is the service safe, effective, responsive and well-led to at least good.

At our last inspection for the key question, ‘is the service safe?’ we found one breach of regulation. We found people were at risk of harm due to unsafe care practices being followed, this included the use of unsafe moving and handling techniques. We also found a staff member had not followed recommended safe practice for administering medicines.

For the key question, ‘is the service effective?’ we found that the service was not working within the principles of the Mental Capacity Act (MCA). People who may not be able to make certain decisions for themselves had not been assessed to determine if they were able to do so. We also identified that there were some staff who had not received the training they were expected to have completed to ensure they knew about the safest and latest best practices in connection with people's care.

For the key question, ‘is the service responsive?’ we found people may not have received the care they required due to this not being clearly explained in their care plans.

For the key question, ‘is the service well-led?’ the service did not have the required systems in place such as policies and procedures.

At this inspection the overall rating of the service was changed to, ‘Good’. We found significant improvements had been maintained and we rated each of our key questions as being, ‘Good’.

There was a registered manager in post. 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.

People were protected from abuse. Staff followed the provider’s safeguarding procedures to identify and report concerns to people’s well-being and safety.

Comprehensive assessments were carried out to identify any risks or potential risks to the person using the service and to the staff supporting them. This included any environmental risks in people’s homes, risks in the community and any risks in relation to the care and support needs of the person.

Staff were recruited safely and trained to meet people’s individual needs. Wherever possible people were only supported by staff known to them and trained to meet their needs. There were enough staff assigned to provide support and ensure that people's needs were met.

People’s needs were met where staff were responsible for supporting medicine administration and ensuring people had enough to eat and drink. Staff supported people to access healthcare services when required. Clear records were kept and issues followed up on. Staff knew how to minimise the risk of infection.

Staff received support, regular supervision and attended training to enable them to undertake their roles effectively.

Staff were aware of the requirements of the Mental Capacity Act [2005] and the Deprivation of Liberty Safeguards [DoLS] which meant they were working within the law to support people who may lack capacity who may need to be referred under the court of protection scheme through the local authority.

People had a care plan that provided staff with direction and guidance about how to meet individual needs and wishes. These care plans were regularly reviewed and any changes in people’s needs were communicated to staff.

People were supported to live a full and active life, offered choice and staff had safeguards in place to support people to experience outings and for activities to go ahead.

People knew how to raise concerns and make complaints. People had details of how to raise a complaint and told us they would be happy to make a complaint if they needed to. We looked at records that demonstrated the complaints procedure had been followed.

There was a management structure within the service which provided clear lines of responsibility and accountability. There was a positive culture within the service and the management team provided strong leadership and led by example.

There were quality assurance systems in place to make sure that any areas for improvement were identified and addressed. The registered manager and care co-ordinators were visible in the office. They regularly visited people in their own homes and sought their views about the service.

Inspection areas



Updated 27 February 2018

The service was safe.

People were protected from abuse and foreseeable risks.

The service had person centred risk assessments relating to people being supported to reduce the risk of any potential harm

There were enough staff to cover visits and ensure people received a reliable service. Checks were carried out when new staff were employed to ensure they were suitable to work in people�s homes.

People received their medicines safely.



Updated 27 February 2018

The service was effective.

Staff were trained and had the skills and knowledge to provide the support people required.

People were supported to have a varied and nutritional diet to keep them healthy.

People had their health needs met and were referred to healthcare professionals promptly when needed.

The service was working within the legal requirements of the Mental Capacity Act (2005).



Updated 27 February 2018

The service was caring.

People were supported by kind and caring staff who knew them well.

People were involved in all aspects of their care and in their care plans. People were encouraged to express their views and to make choices.

People were treated with dignity and respect by staff who took the time to listen and communicate.



Updated 27 February 2018

The service was responsive.

Care was planned and delivered to meet people�s individual needs.

Care plans were person-centred and information about a person�s life history, likes, dislikes and how they wished to be supported was documented.

There were systems in place for receiving and handling complaints.



Updated 27 February 2018

The service was well-led.

Staff told us they enjoyed working at the service and felt valued They said they were able to put their views across to their manager, and felt they were listened to.

There were systems in place to gain people�s views and took action in response to people�s feedback.

The registered manager monitored the quality of the service.