Best At Home (1) Southerton House

Best At Home Domiciliary Care Services Ltd is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection 33 older people were receiving personal care at home from this provider. 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.

People’s experience of using this service and what we found

People and their relatives were mostly positive about the quality and safety of the personal care they or their loved ones received. People agreed the service was moving in the right direction and had significantly improved in the last 12 months.

At our last inspection we found the provider had failed to ensure; staff call visits were always well-coordinated, we were notified without delay about the occurrence of significant incidents that adversely affected the health and wellbeing of people they supported, and they appropriately maintained and audited medicines records.

At this inspection we found enough improvements had been made. People now received consistently safe, good-quality personal care from the same group of punctual staff who were familiar with their needs and daily routines. The provider had also introduced a range of electronic systems to monitor staffs time keeping, their record keeping and medicines management and had created a new quality assurance and compliance manager role to oversee the effectiveness of the providers new oversight and scrutiny systems.

People continued to be protected against the risk of avoidable harm by staff who knew how to keep them safe. The fitness and suitability of prospective new care staff was thoroughly assessed and checked. People received their prescribed medicines as and when they should. People were confident any concerns they raised would be listened to and dealt with appropriately. Staff followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. 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.

Most people and staff were complimentary about the way the office-based managers now led the service, and how approachable they all were. Complaints, concerns, accidents, incidents, and safeguarding issues were appropriately reported, investigated, and recorded. The provider promoted an open and inclusive culture which sought the views of people, their relatives, and staff. People had up to date, detailed, person-centred care plans in place, which were routinely assessed, monitored, and reviewed. Staff had the right levels of training and support to deliver safe care to the people they supported. People were treated with dignity and respect by staff who they typically described as “attentive” and “kind.” The provider worked in close partnership with other health and social care professionals and agencies to plan and deliver people's packages of care at home.

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 (published 26 May 2022) and there were 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

We conducted an announced comprehensive inspection of this service in April 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve how they coordinated staff call visits, managed notifiable incidents they were required to send the CQC and how they maintained and audited medicines records.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Best At Home Domiciliary Care Services Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect. If we receive any concerning information, we may inspect sooner.

Best At Home Domiciliary Care Services Ltd is a domiciliary care agency providing personal care to people living in their own houses and flats in the community. The service provides support to adults over 65 years and people with dementia. At the time of our inspection there were 83 people using the service.

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 did not always receive support from sufficient numbers of staff to keep them safe. Staff did not always stay the full duration of the visit.

We made a recommendation in relation to the registered manager’s record keeping and management.

People’s medicines were managed in line with the prescribing G.P. People continued to be protected against the risk of harm and abuse. Risk assessments gave staff clear guidance on how to mitigate identified risks. The registered manager was keen to ensure lessons learned.

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 received a service that sought their views and acted on information received. Records showed the registered manager worked in partnership with stakeholders and to seek positive outcomes for people receiving care and support. Staff spoke positively about the registered manager describing him as a team player and someone who was approachable.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 7 December 2021).

Why we inspected

This inspection was prompted by concerns identified at the provider’s sister service in relation to staffing levels. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led relevant key question sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Best At Home on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Best At Home (1) Southerton House is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The Care Quality Commission (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 consider any wider social care provided.

People’s experience of using this service and what we found

The agency provided a safe service for people to use and staff to work in. People were supported and had their needs met by sufficient numbers of appropriately recruited staff. This enabled them to live in a safe way and enjoy their lives. Risks to both people and staff were assessed, monitored and updated when required. The agency reported, investigated and recorded accidents, incidents and safeguarding concerns. Medicines were safely administered. The agency met shielding and social distancing rules, used Personal Protection Equipment (PPE) effectively and safely and the infection prevention and control policy was up to date.

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We found and people and their relatives told us the care provided was effective, they had not experienced discrimination and their equality and diversity needs were met. Staff were well-trained, and appropriately supervised, and appraised. People and relatives we contacted, praised the way staff provided care, which met their needs well. Staff encouraged people to discuss their health needs and these were passed on to appropriate community-based health care professionals. The agency had a well-developed professional’s network that enabled seamless joined up working between services based on people’s needs, wishes and best interests. This included any new services required as people’s needs changed. Staff protected people from nutrition and hydration risks, and people were encouraged to choose healthy and balanced diets that also met their likes, dislikes and preferences.

People and their relatives said staff provided them with care and support in a friendly way that they liked, with attention to small details making all the difference. Staff acknowledged and respected people’s privacy, dignity and confidentiality. People were encouraged and supported to be independent and do things for themselves, whenever possible. This promoted their self-worth and improved their quality of life. The staff were caring, compassionate and passionate about the people they provided a service for and the way they provided it.

The agency was responsive. People’s needs were assessed and reviewed including any communication needs and they received person centred care. They were given choices, encouraged to follow their routines, interests and hobbies so that social isolation was minimised. People were given enough information to make their own decisions. Complaints were recorded and investigated.

The agency management and leadership was transparent with an open culture that was honest and positive. The agency statement of purpose clearly defined its vision and values, which staff understood and followed. Staff were aware of their responsibilities and accountability and they were willing to take responsibility and report any concerns they may have. The agency reviewed service quality and made changes to improve the care and support people received. This was in a way that best suited people. The agency had well-established working partnerships that promoted people’s needs being met outside its remit to reduce social isolation. Registration requirements were met.

Why we inspected

This service was registered with us on 22/09/2020 and this is the first inspection.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk