We carried out a review of the data available to us about Better Care at Home East 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 Better Care at Home East, you can give feedback on this service.
Better Care at Home East is a domiciliary care agency. It provides personal care to people living in their own homes. Not everyone who uses the service receives 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 the inspection, 15 people were receiving personal care from the service.
People’s experience of using this service and what we found
A strong person-centred culture was reflected in all aspects of the service. There was an emphasis on ensuring people were supported to live well, and this care and attention extended to those they lived with. It was clear in the way the registered manager and staff spoke with and about people and relatives, and in how care was planned and delivered. Staff demonstrated genuine empathy towards people. People and relatives told us how staff went above and beyond expectations, with acts of kindness that meant a lot to them.
The service was distinctive and innovative in how it trained and equipped its staff to take clinical observations and identify signs a person’s health might be deteriorating. People and relatives spoke very positively about the care received, saying staff were watchful for any changes in their or their loved ones’ health and contacted health professionals as needed. Because of this swift response, people were able to access healthcare without delay, avoiding the need for, or reducing the length of, hospital admissions.
The service worked closely with health and social care professionals, where necessary advocating for people to receive the treatment and equipment needed. This helped to ensure people had an improved quality of life, including being able to do things they cared about as they approached the end of their life.
People experienced an exceptionally responsive service that was tailored to their individual needs and wishes. People’s needs were thoroughly assessed and formed the basis of highly personalised care plans. There had been some simple but innovative reasonable adjustments to promote people’s independence and ensure their care needs were always met. Staff were attentive to people’s preferences and suggested practical ideas to improve their quality of life.
There was a strong emphasis on good nutrition and hydration for health, with close attention to people’s dietary needs and flexibility to accommodate people’s needs and preferences around eating and drinking. Call timings were organised so there was enough time for people to have any support they needed with preparing and eating meals. The registered manager and staff were attentive to poor food intake, poor hydration and weight loss, and the importance of respecting people’s preferences to address this.
People were supported to plan for and have a dignified, comfortable death in their own home, if that is what they wanted. End of life care planning took account of people’s ability to understand and communicate their wishes for the end of their life. Staff had the skills and empathy to understand and meet people’s and families’ needs at this time. Where necessary, the registered manager had provided a high level of practical assistance with arrangements after people died.
People and relatives had confidence in the ability of staff. Only staff of a suitable calibre were employed. However, there was one instance of reliance on an incorrect Disclosure and Barring Service (DBS) check. The registered manager addressed this immediately we drew it to their attention. We have made a recommendation about the service’s DBS process.
People, relatives and staff praised the quality and leadership of the service. They felt the management team were friendly, readily available and supportive. The registered manager encouraged them to give feedback and suggestions, which were promptly acted upon. The registered manager and staff were clear about their responsibilities and the high standards expected of them. The registered manager had clear oversight of the quality of the service.
People and relatives said they felt safe with staff. Managers and staff understood their roles in recognising and responding to abuse. Risks were assessed and managed safely, in a way that was acceptable to people. Staff adhered to infection prevention and control procedures. People received medicines support from trained, competent staff.
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.
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 17 June 2020 and this is the first inspection at which we have rated the service.
Why we inspected
This was a planned inspection based on the date the service was first registered and the focused inspection in November 2021.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Better Care at Home East is a domiciliary care agency. It 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. At the time of this inspection the service were supporting 26 people, of which 18 of these were receiving the regulated activity of personal care from the service.
People’s experience of using this service and what we found
People and relatives spoke extremely positively about the service they received. We were given many examples that showed people received quality care and support from kind, caring staff that so often went the extra mile to ensure people were kept safe, were happy and felt well cared for. One person told us, “In my opinion I would give them 10/10 right the way through and my husband says the same.”
Staff spoke knowledgably regarding all aspects regarding safeguarding people. Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor practice.
Risks were individually assessed, regularly reviewed, clear and covered all areas of people’s health as well as any potential environmental risks. Risks assessments ensured staff were given current guidance and information to enable them to support people safely whilst allowing them to maintain their independence.
People were supported by sufficient numbers of trained, experienced staff to meet people’s needs. People received their support from a small, consistent team of skilled staff that knew people well and delivered their care in ways people preferred.
Safe recruitment practices were followed. Appropriate checks were completed to ensure that only suitable staff were employed. There was a strong commitment to developing and supporting staff through regular training, supervisions, observations and appraisals. Staff spoke positively about the training they received which they told us was well delivered and of good quality.
Staff supported people to take medicines safely. Staff were trained in medicines management and knew how to ensure that people received their medicines on time and as they had been prescribed. Clear audit processes were in place to monitor the accuracy of administering and recording medicines and drive a culture of continuous improvement. Effective relationships had been built with healthcare professionals to ensure safe management of medicines for people.
There were robust procedures in place to ensure people were protected from infections that could affect both staff and people using the service. Staff had completed infection prevention and control training and understood the actions needed to minimise the risk of avoidable harm, including the prevention of avoidable infection. Staff had access to plentiful supplies of personal protective equipment (PPE) and followed current national guidance regarding the Covid-19 pandemic.
People, relatives and staff consistently spoke of the passion, commitment, kindness and approachability of the manager. People felt the service was extremely well led with a strong commitment to providing the very best person-centred care.
Staff told us, and records showed, there was an open, honest, positive culture with a strong ethos on learning and development. Staff were provided with the training, skills and support to provide the best levels of care to people to enable them to live their lives as independently as possible whilst maintaining a good sense of wellbeing and happiness.
Governance systems and oversight of the service were robust. Issues were identified, analysed and discussed with staff to enable learning to be achieved from incidents. There was an open, supportive culture that empowered staff to put forward their ideas for improvement to enable people to receive quality, individualised care that impacted positively on their lives.
People, relatives and staff consistently spoke of the effective and clear communication systems that the registered manager had implemented throughout the service. One member of staff told us, “Communication here is simply brilliant, everything is instant…we have all the information we need straight away, I can’t fault it.”
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 17 June 2020 and this is the first inspection.
Why we inspected
This was a focussed inspection conducted in accordance with current CQC inspection guidance.
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.