The Care Bureau Ltd - Domiciliary Care - Northampton

The Care Bureau Ltd– Domiciliary Care- Northampton is a domiciliary care service providing care to people living in their own homes in Northampton. At the time of our inspection, 101 people were using the service. 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.

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.

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

Right Support:

Risks to people’s care had been identified but there was not always enough information for staff to know how to mitigate the risk. Care records lacked detail about people’s health needs.

People were cared for by staff who knew them, however at times they did not know which care staff would be visiting and the times and length of care calls varied.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff understood the need to seek consent from people before they provided care or completed tasks for people.

Staff were trained and had a good understanding of people’s needs. They supported people, when needed, to access other health professionals. Their competency was tested in relation to medicine administration.

Right Care:

People’s care was not always person-centred. At weekends the scheduling of people’s calls was not always at the time when people wanted. At times staff were stretched to provide the full support people needed.

People felt safe with staff and said most staff knew how to support them. Staff were recruited safely and knew how to protect people from harm or abuse.

Care plans demonstrated people's equality characteristics were considered and respected.

Right Culture

Improvements were needed to the system in place to monitor the quality and performance of the service.

Care records were reviewed but audits had not identified gaps in information and the information was not always up to date.

People and relatives had mixed views in relation to communication with the service and whether they were asked for feedback. Staff were supported but did not always feel they were listened to. The registered manager shared evidence of feedback they had sought.

The registered manager was open and transparent and implemented changes based on the feedback given.

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 12 July 2019)

Why we inspected

We received concerns in relation to management of care calls, poor hygiene practices and lack of oversight. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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 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 The Care Bureau Ltd – Domiciliary Care- Northampton on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to governance and oversight of the service.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

The Care Bureau Ltd - Domiciliary Care - Northampton is a community service. The service supports people to live in their own homes within the community. At the time of the inspection the provider confirmed the service was providing personal care to 98 older adults. Not everyone using 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

Staff understood how to protect people from the risk of harm and understood potential signs of abuse. People were involved in assessments of potential risks to their safety and in identifying measures to keep them safe. People received their medicines as prescribed and were protected from the risk of infections through staff working practices.

There were enough staff to meet people’s needs. Staff went through a thorough recruitment process so that the provider only employed suitable staff. Staff undertook induction training that supported them to have the knowledge and skills to do their job well and effectively meet people’s needs.

People were provided with care and support that ensured they had good nutrition and hydration and access to healthcare that maintained their health and wellbeing. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People's support plans provided guidance for staff to follow. Staff knew people well and had developed positive relationships, which helped to ensure good communication and support. Staff respected people’s privacy and dignity and encouraged people to be as independent as possible.

People were fully involved and consulted when making changes to how their support was provided. Staff knew and understood the needs of the people using the service and care was provided based on their assessed needs. Staff were responsive to changes in people's needs to ensure people received timely intervention to maintain their health and well-being.

People and relatives knew how to raise any concerns or make a complaint. The provider's complaints policy provided information about how these would be managed and responded to.

Systems were in place to monitor the quality of care and support people experienced through quality assurance systems and processes to drive improvements within the service.

People, relatives and staff spoke positively about the management and leadership of the service. They commented the staff were reliable, caring, polite and friendly, and they had built good relationships with them.

The provider listened to feedback and acted immediately to make improvements to the service. The service worked in partnership with external agencies to ensure people achieved good outcomes from their care and support.

Rating at last inspection: The Care Bureau Ltd - Domiciliary Care - Northampton was registered on 25 May 2018 and this was the first inspection.

Why we inspected: This was a planned inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk