7 August 2018
During a routine inspection
Q Care Bracknell is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. The service also provides personal care to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for extra care housing. Not everyone using Q Care Bracknell receives personal care. CQC only inspects the service being received by people provided with help with tasks related to personal care, hygiene and eating. It provides a service to older people and also those with dementia, mental health needs, physical disabilities, learning disabilities and/or autistic spectrum disorder.
Q Care Bracknell was added to the provider's registration on 27 April 2018. Before that the office operated as a satellite of the provider's location at Q Care- Ross on Wye. From mid-August 2017 they started to provide personal care to people living in Bracknell. Some concerns were raised with the Bracknell local authority regarding the running of the service at that time.
After Q Care Bracknell was added as a new location to the provider's registration in April 2018, the provider set up a satellite office in Sutton, providing personal care under contract with the local authority in that area. The Sutton office was run as a satellite office of Q Care Bracknell, with the registered manager of Q Care Bracknell being responsible for the running of the Sutton satellite office. Originally the provider filed an application to add the Sutton office as a location to their registration, but in July 2018 they gave ten days' notice to the local authority in Sutton that they would no longer be able to provide the service in that area. The provider withdrew their application to add Q Care Sutton to their registration and the care packages in that area were handed back. At the time of this inspection there were no further satellite offices running out of Q Care Bracknell and the provider advised us there were no plans to do so. The 25 people using the service when we inspected were all living in the Bracknell area.
The service did not have a registered manager as required of their registration. 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 provider had recruited a new manager, who was expected to start working at the service on 10 September 2018. From June 2018 the provider had employed an independent consultant to oversee the management of the service and start to identify improvements needed and implement them. Plans at the time of the inspection were that the consultant would remain at the service until the new manager had started work and settled into his role.
People were mostly safeguarded from risks. However there had been a number of safeguarding concerns raised in the 12 months prior to our inspection. The areas of concern mostly related to late calls, missed calls, communication and potential health concerns not being reported. Actions were being taken to address those concerns and reduce risk in those areas. However, at the time of our inspection there was no effective system for the provider to ensure the service was fully compliant with the fundamental standards and a requirement has been made.
People were treated with care and kindness and could change how things were done during a visit if they wanted to. People were treated with respect and their dignity was upheld. This was confirmed by people we spoke with and relatives who provided feedback.
Some staff recruitment issues were identified by us during the inspection, but were dealt with by the office staff immediately following the first day of the inspection.
People received care and support from staff who knew them and felt well trained and supported. Medicines were mostly handled correctly and safely but some medicines had been missed when calls had not taken place as scheduled. The service was aware of the issues and action was being taken to reduce the number of missed calls and medicines.
People's rights to make their own decisions were protected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People confirmed they were encouraged and supported to maintain and increase their independence.
People spoke to care staff if they had any concerns and felt they responded well to any concerns raised. People's diversity needs were identified and incorporated into their care plans. People's right to confidentiality was protected and they received support that was individualised to their personal preferences and needs.
We found breaches of one regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had not established an effective system that ensured their compliance with the fundamental standards. The fundamental standards are regulations 8 to 20A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.