Bevancare LTD

Bevancare Ltd is a domiciliary care service providing personal care and support to people living in and around Rochdale. 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. At the time of our inspection the service were supporting 37 people with the regulated activity of personal care.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were 3 people using the service who have a learning disability and/or who are autistic.

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.

We found improvements were required with care documentation and with the monitoring of care visit times. Medicines records had not always been completed accurately and there was important information missing. We received mixed comments from people and family members about the timing of their visits, with some visits occurring too close together.

The service had a robust recruitment process which ensured suitable staff were employed. Staff followed correct infection control practices.

People had care plans which described how they wished to be supported. The service was in the process of moving from a paper-based to an electronic system for their care records and medicine administration records.

People and family members were happy with the attitude of staff. They told us staff were kind and caring. We saw positive interactions between staff and people living in the supported living setting we visited.

People, family members and staff were complimentary about the management of the service. Staff told us they enjoyed their work and were well-supported by the registered manager.

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

Why we inspected

The inspection was prompted in part due to concerns received about the service. A decision was made for us to inspect. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led. 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.

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

Enforcement and Recommendations

We have identified a breach in relation to the administration of medicines. Please see the action we have told the provider to take at the end of this report.

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.

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

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.

Risks to individuals and staff were identified and well managed. Care records guided staff on the support people needed to manage those risks. Staff were aware of how to raise safeguarding concerns. The required pre employment checks were made and there were sufficient staff to meet people’s needs. The provider had started to use an electronic call monitoring system to improve their oversight. There was a system in place for the safe administration of medicines. The risks associated with Covid-19 had been well managed.

Care records were person centred, and covered people's identified needs and preferences. There was regular review of the care and support provided including quality questionnaires. Staff knew people well; they spoke with affection about the people they support. People’s communication methods were respected. Records relating to people’s end of life wishes were very person centred and respected people’s choices.

The registered manager understood their responsibilities. People described the registered manager as approachable and fair. Quality monitoring and auditing was in place. Improvements to quality monitoring had been introduced and were still being embedded. There was a system in place to manage complaints. Some people told us they had experienced difficulties with changes in staff recently, but that managers had listened and improved consistency. Staff and most people were very positive about the service and the way it was run. One staff member said, “I love it. It’s one of the best jobs I have ever had.”

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

Rating at last inspection and update: The last rating for this service was requires improvement (published 14 March 2020) and there was one breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

Why we inspected

We undertook this focused inspection to check the service had followed its action plan and to confirm it now met legal requirements. We also received concerns in relation to staff recruitment, staffing, management of risk including staff training, records of care and medicines management. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, responsive and well-led sections of this full report.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for safe, responsive and well-led on our website at www.cqc.org.uk.

Office G6, known as Bevan Care and referred to as such in this report, is a domiciliary care agency providing personal and social care to people living in their own homes. 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 staff do support people with personal care, we also consider any wider social care provided. At the time of the inspection, the service was supporting eleven people with personal care.

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

People told us they were happy with the support they received from Bevan Care and had developed positive relationships with their care staff. They told us staff were vigilant to their needs and helped to keep them safe. However, systems to maintain a good quality serviced were not robust, and this was a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Risks were assessed, and support plans had been produced for each person who Bevan Care supported. Although people told us they were asked about their needs and how they should be addressed, support plans and risk assessments did not always provide sufficient detail to guide staff in meeting identified needs, and there had not been any reviews of people's needs. We made recommendations that where risk was identified, instruction be provided to guide staff to minimise the risk and that reviews be conducted for all people using the service.

There were processes in place to monitor the safety and quality of the service. Senior staff undertook quality assurance monitoring of the service and any actions arising from this had been addressed, but quality audits did not always identify gaps in recording information, such as the dates records had been completed.

People were aware of how to complain and told us that when they had made complaints these resulted in improvements in their support. However, records of complaints lacked any detail to show how the complaint was investigated or how they had been resolved.

All new staff undertook an induction and were offered appropriate ongoing training to carry out their role. Where people had specific needs, training was provided to meet these needs. One person told us, “I think [the staff] are well trained and know how best to support me.”

Care records and progress reports showed attention to people’s health care needs, and staff understood and met any specific dietary requirements people might have. Records showed referrals were made to various agencies such as GPs, district nurses and diabetic nurses.

Care staff were kind and caring. People confirmed staff sought their consent before undertaking any care task or entering their home and that they would always offer choices around how their care was provided. They told us that the care staff had enough time to perform tasks and would spend time listening to what they had to say. Privacy and choice were respected, and confidential information was kept securely.

People were given opportunities to provide feedback on the quality of their support and the service they received.

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

Rating at last inspection

This service was registered with us on 30 August 2018 and this is the first inspection.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe, 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.

Enforcement

We have identified a breach in relation to the way the service is being managed. Please see the action we have told the provider to take at the end of this 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 to monitor progress. We will

return to visit as per our re-inspection programme. If we receive any concerning information we may inspect

sooner.