Background to this inspection
Updated
5 January 2022
The inspection
We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.
Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.
Inspection team
The inspection was carried out by one inspector.
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 (CQC). 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. There was also a branch manager.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since it registered with CQC. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with five people and six relatives about their experience of the care provided. We spoke with seven staff including the branch manager and registered manager.
This performance review and assessment was carried out without a visit to the location’s office. We used technology such as video calls and telephone calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation. Inspection activity started on 7 December 2021 and ended on 14 December 2021.
We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
5 January 2022
About the service
Beech Tree Total Care Dover & Deal is a domiciliary care agency providing personal care to people in their own homes.
Not everyone who used the service received personal care. The Care Quality Commission (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 the inspection 76 people were receiving this support. Most of the people supported were older people or people with a physical disability.
People’s experience of using this service and what we found
Guidance for staff about how to move people safely, when using special equipment, did not contain enough detail to make sure people would be supported to move safely. The management team began to review the guidance in place and update them during the inspection.
Covid-19 staff risk assessments had not been recorded in line with Government guidelines. The registered manager took immediate action to address this.
Risks to people’s health and safety were assessed, monitored and regularly reviewed. People were protected from the risks of abuse and discrimination. People were supported to have their medicines as prescribed.
People and their relatives told us they felt safe receiving support from staff. People were supported by regular staff who arrived on time and stayed the length of time expected. One person said, “I am very lucky. I insisted on having a team of consistent carers. It is very important to me. They are very good carers.”
People were supported by staff who had been safely recruited. Staff completed regular training and met with the management team to discuss their performance. Spot checks were completed to check staff competency.
Staff wore personal protective equipment (PPE), such as face masks and gloves. Staff completed infection prevention and control training and told us they had access to plenty of PPE. People told us staff always wore PPE when they visited them.
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.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• Model of care and setting maximises people's choice, control and independence
People were supported to make choices and to be as independent as possible. People were empowered to reach their personal goals, and this had positive outcomes for people. Staff spoke with compassion about the people they supported.
Right care:
• Care is person-centred and promotes people's dignity, privacy and human rights
People received care and support that was planned with them and their relatives and centred on them as an individual. There was a holistic approach to planning people's care where people's physical, psychological, emotional and social care needs were assessed with them. People's privacy and dignity were respected, and their human rights protected.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives
The registered manager and staff worked as a cohesive team and followed a clear set of values. There was clear, visible leadership. The registered manager and branch manager led by example. People, relatives and staff spoke positively about the leadership of the service.
People’s physical, mental health and emotional needs were assessed before they began using the service. Care plans were developed with people and their relatives and provided staff with information about how people preferred to be supported.
People told us staff were kind and caring. One person said, “Staff who come out are brilliant. They are really friendly. They make time to stop and chat.”
People and their relatives knew how to complain and did not have any complaints about the service.
People, relatives and staff felt the service was managed well. They all felt the communication was good. Regular checks were completed to monitor the quality of the service.
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 23 June 2020 and this is the first inspection.
Why we inspected
This was a planned inspection based on our inspection programme.
This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.
We have found evidence that the provider needs to make improvement. Please see the Safe and Well-Led sections of this full report.
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.