Background to this inspection
Updated
23 July 2021
The inspection
This was a focused inspection to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 12 (Safe care and treatment), Regulation 17 Regulation (Good governance), Regulation 18 (Staffing) and Regulation 19 (Fit and proper persons employed), of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Inspection team
The inspection was undertaken by two inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 03 June 2021 and ended on 08 June 2021. We visited the office location on 04 June 2021 and 08 June 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service and five relatives about their experience of the care provided. We spoke with four members of staff including the registered manager, a senior care worker and two care workers. We spoke with a health and social care professional, to ask their views of the care provided to people.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and training. A variety of records relating to the management of the service, including spot checks on the care provided by staff and quality assurance checks with people in receipt of care.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at policies and procedures.
Updated
23 July 2021
About the service
Bromyard Home Care Agency Limited is a service providing personal care to people in their own homes. At the time of the inspection 24 people were receiving care.
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
Governance systems had improved but required additional time to embed to reduce risks to people further. Governance systems in relation to the recording of to staff competencies to administer people’s medicines and processes for ensuring people received their medication as planned required further development. The provider gave us their assurances they would promptly address this. The provider planned to review their key policies so they could demonstrate these followed the most recent best practice guidance.
People, relatives and staff told us communication with the registered manager was good. They were confident if they made any suggestions for improvements these would be addressed without delay . People and relatives said the staff focused on people’s needs and described the culture of the service as warm, open and honest. Staff told us Bromyard Home Care Agency Limited was a good place to work because they felt supported and listened to.
People told us staff talked with them about their safety and took appropriate steps to assess their safety needs. Staff had received training to recognise abuse and were confident any concerns they escalated would be addressed. There was a consistent staff team supporting people who knew their safety needs well. Information was available to support staff to administer people’s medicines safely.
People were positive about the skills and knowledge staff had developed to care for them. People were involved in assessing their care needs and their views were taken into account when their care plans were developed. People’s families were consulted as part of this process where appropriate. This helped people to achieve good health and well-being outcomes. Staff worked with other health and social care professionals to ensure people’s health needs were met.
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.
Rating at last inspection and update.
The last rating for this service was Requires Improvement, (last report published 28 April 2020) and there were multiple breaches of regulation. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. However, at this inspection further time was required to embed these improvements and to continue to develop governance systems and practice.
The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We undertook this focused inspection to confirm the provider now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion 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 Bromyard Home Care Agency Limited on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.