Bhandal Care

Updated 20 December 2023

Inspection team

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 1 inspector and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.

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.

What we did before the inspection

We received feedback from the local authority who commissioned care from the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

Inspection activity started on 31 October 2023 and ended on 10 November 2023. We visited the location’s office on 7 November 2023.

We spoke with 7 people and 6 relatives of people who used the service. We spoke with 4 staff in total, including the registered manager and 3 care staff.

We reviewed the relevant parts of 4 people's care plans and 3 people’s medicines records. We looked at audits, policies, training records and 3 staff recruitment files.

Updated 20 December 2023

About the service

Bhandal Care is a domiciliary care agency. The service provides personal care to older and younger adults, who may also be living with physical and sensory disabilities, dementia, mental health or learning disability and / or autism. At the time of our inspection there were 28 people using the service.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people

The service was not able to demonstrate how they were meeting some of underpinning principles of “Right Support, Right Care, Right Culture.

Right support: We have made a recommendation about care plans. Care plans did not always have sufficient detail on behaviours that challenged to ensure staff provided consistent care. Care plans and risk assessments were in place for other areas of people’s care needs. Systems were in place to help protect people from the risk of abuse. There were enough staff for people to receive timely care and checks on the suitability of staff to work at the service had been made. Steps were taken to help prevent the risks from infections. Medicines were managed safely and lessons were learnt when things went wrong.

Right care: 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’s needs were assessed and staff were trained in areas relevant to people’s care needs. People were supported to eat and drink well and staff worked with other agencies to help people receive effective care.

Right culture: Some improvements were still required in the management of the service. Staff treated people well and people were supported to express their views and be involved in their care. People were supported with their independence and their dignity and privacy was respected. The provider looked to improve the quality of care in response to feedback. People’s communication needs were assessed and staff checked people’s preferences and choices. The provider involved people, staff and relatives in the running of the service and worked in partnership with other agencies involved in people’s care.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 20 February 2023). At our last inspection we found breaches of the regulations in relation to assessment and risk management of people’s care needs, staff recruitment processes, staff deployment, skills and knowledge, complaints systems, record keeping and management of the service.

The provider completed an action plan after the last inspection to tell us what they would do and by when to improve. At this inspection, we found the provider had made some improvements and some improvements were still required and they remained in breach of regulations.

This service has been in Special Measures since 20 February 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out this inspection to follow up on action we told the provider to take at the last inspection.

Enforcement and recommendations

We have found breaches in relation to the management of the service at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

We have made a recommendation in relation to care plans for when people express distress and agitation. We will check if the provider has acted on any recommendations at our next comprehensive inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.