We carried out a review of the data available to us about Butterfly Care (Bath, Wiltshire and Somerset) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Butterfly Care (Bath, Wiltshire and Somerset), you can give feedback on this service.
Butterfly Home Help (Bath and Wiltshire) is a domiciliary care service that provides personal 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 they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People were supported to manage their medicines safely, guidance on support people needed with their medicines was recorded in care plans.
People were being supported by sufficient numbers of staff, there had been no missed visits. Risks had been identified and assessed, staff reviewed risk management plans regularly. People were being supported by staff who had received training in safeguarding and understood how to report any concerns.
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. People were supported by staff who were trained and supported by the service. People’s needs were assessed and where needed, support was provided to access health services.
People were being supported by staff who were kind and caring. People were happy with their care workers and talked about them fondly. One person told us, “Staff are all very helpful, professional, very kind, sociable and really lovely.” One relative told us, “The staff that we get here are first class really caring. They are friends, not just carers and they have the right attitude.” People’s dignity was promoted and maintained, and their independence promoted.
People had individual plans of care that were updated regularly. The service aimed to provide people with a core group of workers so that they received a consistent service. People told us staff did not rush their care and had time to sit and chat. People had support to record their wishes for end of life if they wanted to. The service liaised with healthcare professionals for support to provide palliative care.
People received their care and support from an open and inclusive service. Staff told us they enjoyed their jobs and felt valued. People, relatives and staff told us the service was well-managed. People and their relatives knew how to complain, and we saw complaints were logged and investigated.
Quality monitoring systems were in place which identified improvement and the provider was striving to continuously improve and develop the service. Partnership working was evident with good relationships being formed with the local community and healthcare professionals. One professional told us, "Butterfly are one of the best agencies I have ever worked with."
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 (Report published 13 June 2018) and there were two breaches 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.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our inspection schedule. If we receive any concerning information we may inspect sooner.
Not everyone using Butterfly Home Help receives 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.
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.
Staff were not safely recruited. The provider had not always asked for a full employment history of staff prior to starting work at the service. Where there were gaps in employment history, these had not been explored with the member of staff to determine the reason. When staff had started prior to a satisfactory check with the disclosure and barring service, the service had not assessed the risks.
Risks had not always been assessed, so that safety measures could be put in place. There was not always clear guidance for staff on how to use equipment needed to keep people safe such as bed rails.
Quality assurance systems were not robust. There were no overarching quality assurance documents and action plans for the service as a whole. Only the satellite office in Bath produced monitoring information.
We have made a recommendation that the service reviews its quality monitoring systems.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the systems in the service supported this practice.
Medicines were managed safely and staff had received training in administration of medicines prior to doing that activity. There were sufficient staff employed and available to meet the care packages the provider had agreed to.
Staff understood their responsibility to keep people safe from harm. They had received training on safeguarding and knew the signs to be aware of. If needed the staff would have no hesitation reporting abuse and were confident the office would take appropriate action.
Training and supervision was provided to staff and updated when needed. Staff told us they felt supported and could ask for training in any area. People and their relatives told us they felt staff were well trained and had the skills needed to do their jobs.
Personal protective equipment was supplied to staff and people told us the staff wore it when supporting personal care.
People were supported to access healthcare if needed; the service supported them to call GP’s, district nurses or any other healthcare professional.
People and their relatives thought the service was caring and the staff respected their privacy and dignity. Person centred values were demonstrated by staff that told us they enjoyed the work they did. Care plans were person centred and people told us they had been involved in their assessments of care needs. People felt listened to and were able to have a review on a regular basis.
Confidential information was kept secure and only authorised personnel were able to access records. Staff used hand held devices to record daily notes, which required a password to access.
Complaints were well managed and records demonstrated all complaints were logged with the action that had been taken. People, their relatives and staff told us they thought the service was well managed. Staff found the management to be open, transparent and approachable.
At our last inspection carried out in July 2013, all the legal requirements were met; at this inspection, we have found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This is the first time the service has been rated as requires improvement. You can see what action we told the provider to take at the back of the full version of this report.
We spoke on the telephone with people and/or relatives of people who used the service provided by Butterfly Home Help. A relative said: "they are extremely good. They were very pleasant when setting everything up and my confidence was not misplaced." Another person who was supported by the service said: "they are all very helpful. I feel very safe and well looked after by them all."
People and their relatives told us their needs or those of their family member had been well assessed and safely managed by the service. People said they were treated with privacy, dignity and respect. We were told by a lot of people we spoke with that, for them, the most important part of the care provided was having just a small number of different carers. They felt this provided consistency of care and staff got to know people well.
We found the organisation had effective recruitment practices to assure staff employed were able to work with people safely and effectively. Staff worked with other health and social care professionals when this was required to ensure care was coordinated. The organisation also used its knowledge, experience and systems in place to ensure it was able to keep to its appointed time to visit people. This involved having sufficient staff, scheduling staff visits carefully, and factoring in planned and unplanned staff absence.