Brockton Care Limited

Brockton Care Limited provides personal care within people's own houses and flats. At the time of our inspection 164 people, were using the service. 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.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The service was able to demonstrate how they were meeting underpinning principles of "Right Support, Right Care, Right Culture .

Right Support: The principles of the mental capacity act were not always observed to presume people had capacity unless indicated otherwise. Staff supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives. People’s involvement in their care assessment ensured they received a service that reflected their preferences.

Right Care: The management of medicines placed people at risk of not receiving their medicines as directed by the prescriber. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff work practices ensured people were protected from the risk of avoidable infections.

Right Culture: The provider’s governance was ineffective to review and ensure staff received relevant training in relation to people’s health condition. Although, systems were in place to monitor calls, people at times experienced late and missed calls. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.

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 5 April 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Brockton Care Limited on our website at www.cqc.org.uk.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults.

The agency had a registered manager who was also the registered manager who was present on the day of our inspection visit. 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.

At our previous inspection in September 2016, staff lacked understanding of the principles of the Mental Capacity Act [MCA] 2005. At this inspection staff demonstrated a good understanding of MCA and had incorporated this in their care practices to ensure people’s human rights were protected.

At the previous inspection we found that the provider’s governance was ineffective to ensure the monitoring of medicine practices. At this inspection improvements had been made to ensure medicine practices were monitored and staff had the appropriate skills to assist people with their prescribed treatment.

People informed us about complaints they had shared with the provider. However, these complaints had not been recorded to show what action had been taken to resolve them or to monitor complaints for trends.

People told us they felt safe using the service and staff were aware of how to safeguard them from the risk of potential abuse. Risk to people was managed effectively to reduce the risk of harm to them. People were cared for by sufficient numbers of staff who had been recruited safely. Staff had been provided with training about how to reduce the risk of cross infection and they had access to essential personal protective equipment. The registered manager said no one in their care had sustained any accidents or near misses. However, systems were in place to record and monitor these if and when they occurred.

People’s consent was obtained before care and support was provided and they were assisted to access relevant healthcare services when needed. Staff assisted people to prepare their meals and took the relevant action where people did not eat and drink sufficient amounts to promote their health. People were cared for by skilled staff who were supported in their role to provide an effective service.

People told us staff were kind, friendly and were aware of how to care for them. People’s involvement in their care planning ensured their specific needs were met and staff respected their right to privacy and dignity.

The assessment of people’s needs with the involvement of other healthcare professionals ensured they were provided with the relevant support and where needed they were also assisted to pursue their interests.

The involvement of other healthcare professionals ensured the provider was able to provide a service specific to the individual’s needs. People were aware of who the registered manager was and found them approachable. People were able to express their views about the service they received. Staff were also given the opportunity to have say about how the service was run. The provider had systems in place to monitor the quality of service provided to people.

Brockton Care Limited provides personal care to people living in their own homes. At the time of our inspection the service was supporting sixty four people.

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. The registered manager was also the director of the company.

People consented to their care and support, however the principles of the Mental capacity Act were not always understood and appropriately applied.

The registered manager had some quality checks and audit processes in place, however these required further development. The registered manager was not always meeting their legal obligations to notify us of certain event such as specific incidents or allegations of abuse. People did not always receive their care calls on time and whilst the registered manager had systems in place to monitor and address such concerns these systems required further improvement.

People were supported by staff who could recognise potential signs of abuse and were confident reporting concerns regarding people’s safety. People were supported by sufficient numbers of staff who had been recruited safely. Risks to the health, safety and well-being of people were identified, managed and regularly reviewed. Staff were able to tell us about people’s individual risks and how to manage them. People received their medicines on time and as prescribed. There were regular medicines administration checks being completed to ensure people received their medicines safely.

People were supported by staff who had the required skills and support to perform their duties of personal care.

People were provided with a choice of food and drink when required and dietary needs were identified and appropriately managed. People were supported to maintain good health and had access to healthcare when required.

People were supported by staff who were caring and treated people with kindness and respect. People were encouraged and supported to make choices about their care and support and staff supported people in a way that maintained their privacy and dignity and promoted their independence.

People and their relatives felt involved in the assessment, planning and review of their care and support needs. People were supported by staff who had a good understanding of people needs and preferences and supported people to engage in activities which they enjoyed. People and their relatives knew how to raise a concern or complaint and told us concerns and complaints were acted on.

People told us their care and support needs were always taken care of and were overall complimentary about the management of the service. People and their relatives knew who the registered manager was and staff told us the manager was visible, approachable and supportive. People, relatives and staff were encouraged to give feedback on the service.

We spoke with people who received a service and they told us that they felt safe. They said that people treated well them and this offered them reassurance and comfort. They told us that they thought staff were well trained and knew how to do their job well. People told us that they felt their rights and dignity were respected.

We saw that safeguarding procedures were robust and staff understood how to safeguard people they supported.

We saw that risks to people's safety and welfare was assessed and when necessary actions were taken to reduce risks. Staff gave us examples of how risks were managed within people's own homes. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. When they were unable to take part in this process their representatives were involved. They told us that needs were met in ways that people preferred and that support was flexible to meet people's changing needs. People said that their care plans were up to date and reflected their current needs.

Is the service caring?

We spoke with seven people supported by the service. We asked them for their opinions about the skills and experience of the staff. Feedback was very positive. One person told us, 'They provide excellent care'. Another person told us, 'They are absolutely fabulous'.

When speaking with the registered manager and the staff it was clear that they genuinely cared for the people they supported. Our feedback from people who received a service reflected this.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Responses seen from the latest survey was overwhelmingly positive. We looked at care plans and saw that people's preferences, interests, aspirations and diverse needs had been recorded. People told us that care and support had been provided in accordance with people's wishes.

Is the service responsive?

During our inspection we saw how the registered manager and staff team were able to make changes to the timing of a visit to accommodate a medical emergency. Records showed how the provider worked well with other agencies and services to make sure people received consistent care.

People knew how to make a complaint if they were unhappy. People who spoke with us said that they would always ring the office if they had any worries or concerns but all stressed that they did not have any.

Is the service well-led?

The service had a quality assurance system. We saw how the registered manager did regular reviews and audits. They told us that they had effective monitoring tools that reassured them that they provided a good service. The manager also told us how they planned other checks and audits to further develop this process. The registered manager demonstrated how they stayed abreast of current best practice and new initiatives. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities. This helped to ensure that people received a good quality service at all times.

We found that the recruitment process followed by the service was safe. We also found two of the staff had not received the training needed to keep the people to whom they provided a service safe from harm.

People told us that their assessed needs were met in ways that they preferred. They said that they were encouraged to remain independent and develop skills to enable them to do this. Assessments of people's needs were seen to be detailed and support plans were developed from information provided. We saw that risks were assessed and plans were in place to reduce and manage them.

Staff told us that they enjoyed their jobs and were aware of their individual roles and responsibilities. They told us that the manager was approachable and supportive. Staff said that they worked well as a team. They also said that they had good training opportunities. We saw certificates to reflect training undertaken.

Staff recruitment files seen contained information to demonstrate a thorough process for checking staff suitability. Staff told us that they received a good induction that prepared them for their role.

Given the size of the agency, people who received a service had regular and ongoing contact with the manager. The manager regularly supported people and visited them to assess and monitor the quality of the service provided. Systems were in place to formally monitor processes as the service expands and develops.