Archived: Black Country Care - Supported Living and Home Care

Enforcement: At this inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the registered provider to take at the back of the full version of the report.

People’s experience of using this service:

People were not always kept safe because risks were not always assessed, monitored or mitigated. We received mixed views on staffing levels. People’s medicines were not consistently managed well. Accidents and incidents were not being consistently investigated and followed up. Where lessons could be learned to improve the service and make the care people received safer; these were not always identified and addressed. Staff described how they would keep people protected from potential harm and knew how to report allegations of poor practice

People received care and support from staff who had not always completed key and specialist training to meet people’s individual needs. People told us that staff sought their permission before providing care and support. However, we identified that the registered provider had not consistently understood their obligations under the Mental Capacity Act (2005). People told us they enjoyed their meals and they chose what they preferred. People were supported to meet their health care needs, when necessary.

People were supported by kind and caring staff that knew them well. Staff protected people's privacy and dignity when supporting people. People were supported to be as independent as possible.

People’s care plans were person centred and staff told us they worked hard to ensure people were supported as individuals. People and their relatives knew who to contact if they had any complaints.

The provider had some systems in place to enable them to assess and monitor the quality of the service provided, but these systems were not being used effectively to manage all aspects of the service. The quality monitoring and assurance processes were not effective in ensuring that the risks to people's health and safety were appropriately assessed, monitored and mitigated.

Rating at last inspection: The service was rated Good overall. Our last report was published on 22 October 2016.

Why we inspected: This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

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

Black Country Care are registered to deliver personal care. They provide support to older people living in their own homes. At the time of our inspection 120 people were accessing this care through the provider. The service also provides a supported living service, where people hold their own tenancy and staff support them within the property. 17 people were using this service.

The service had a registered manager. 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 supported people in a way that made them feel safe. Staff understood the procedures they should follow if they witnessed or suspected that a person was being abused or harmed. Criminal records checks were undertaken before staff were able to begin their role. People were supported to take their medication at the appropriate times. People received the support they needed and were satisfied with the timings of calls. Staff had a detailed knowledge of the risks posed to people and acknowledged people’s risk assessments.

Staff had the skills and knowledge required to support people effectively. Staff received a detailed induction prior to them working for the service and they felt prepared to do their job. Staff could access on-going comprehensive training and regular supervision to assist them in their role. Staff knew how to support people in line with the Mental Capacity Act and gained their consent before assisting or supporting them. Staff assisted people to access food and drink and encouraged people to eat healthily. Staff knew who to contact to support people’s healthcare needs.

People were involved in making their own decisions about their care and their own specific needs. People felt listened to, had the information they needed and were consulted about their care. Staff provided dignified and respect to people. People were encouraged to retain a high level of independence with staff there ready to support them if they needed help.

People’s preferences for how they wished to receive support were known and always considered by the care staff. Staff understood people’s needs and provided specific care that met their preferences. Staff considered how people’s diverse needs should be met. People knew how to raise complaints or concerns and felt that they would be listened to and the appropriate action would be taken. The provider requested feedback from people using the service and staff and acted upon information received.

People were happy with the service they received and felt the service was led in an appropriate way. Staff were well supported in their roles with a clear management structure. Staff felt that their views or opinions were listened to. Quality assurance audits were carried out to look for patterns and trends that may impact upon how the service is delivered.

Staff had the information they needed to know how to support people who used the service to meet their individual needs.

People were supported to do the things they wanted to do. One person told us, 'I went to a club this morning and I'm out here this afternoon. On Thursday I'm going out in the morning, shopping in the afternoon and then out to celebrate another person's birthday in the evening. I'm also going out on Friday, I love going out.'

Systems were in place to ensure that people who used the service were safeguarded from harm and abuse.

Medicine management systems in place were safe so that people received their medicines as prescribed to ensure their safety and wellbeing.

Recruitment processes ensured that staff were employed who had the appropriate skills and knowledge to safely meet people's needs.

People, their relatives and staff were asked for their views about the service and these were listened to. One person told us they had chosen how their bedroom was decorated, they said, 'I have my own nice room, it's been redecorated and I have had new flooring.'