Broad Oak Manor Domiciliary Care

Updated 27 July 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The membership of the inspection team:

The inspection was undertaken by one inspector.

This inspection site visit took place on 6 June 2019 and was announced.

Service and service type:

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It also provides an assisted living service with access to a night shift warden. Seven people were receiving this service.

Not everyone using Broad Oak Manor Domiciliary Care receives the regulated activity of personal care. 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 take into account any wider social care provided.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection.

We gave the service five days’ notice of the inspection site visit because some of the people using it could not consent to a home visit from an inspector, which meant that we had to arrange for a ‘best interests’ decision about this. We needed to speak with relatives of people who lacked the mental capacity to do this.

What we did before the inspection:

Before the inspection the provider completed a Provider Information Return (PIR). This is information we require providers to send us at least annually. This provides us with information about the service, what the service does well and improvements they plan to make. We used this information to assist us with the planning of this inspection. We also looked at other information we held about the service. This included information from statutory notifications the provider sent to us. A notification is information about important events which the provider is required to send to us such as incidents or allegations of harm.

What we did before the inspection:

Prior to our inspection we contacted the local safeguarding authority and commissioners of the service to ask them about their views of the service. These organisations’ views helped us to plan our inspection.

What we did during our inspection:

The inspection took place between 29 May 2019 and 12 June 2019. It included speaking with relatives by telephone and contacting health professionals and the local safeguarding teams. We spoke with three relatives by telephone and received feedback from two health professionals.

We visited the office location on 6 June 2019 to see the registered manager and the nominated individual who has overall responsibility for the quality of service provision. We spoke with the general manager who is also a registered manager for the provider's other service, one team leader and two care staff. We also spoke with another staff member on 12 June 2019, as they were off duty on 6 June 2019.

We looked at two people's care records and their medicines' administration records. We also looked at staff training and supervision planning records and other records relating to the management of the service. These included records associated with audit and quality assurance, accidents and incidents, compliments and complaints.

Updated 27 July 2019

About the service:

Broad Oak Manor Domiciliary Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It also provides assisted living to people with more independence. It provides a service to people living with dementia, people with a physical disability, older people and people with sensory impairments. Its office is based in a rural area of Hertford. At the time of our inspection visit there were seven people receiving a service of personal care.

The service is on the same site as another of the provider’s services, Broad Oak Manor Care Home. Also on site is a converted barn that people can use to socialise. This contains comfortable seating areas, a television and a café area that members of the public can also use.

Peoples experience of using this service:

People’s care was person centred and based on what was important to them. People's concerns were dealt with and acted on before they became a complaint and to the person’s satisfaction. One staff member told us how they danced to encourage a person to get out of bed. Systems were in place to meet people’s end of life care needs and help ensure a dignified and pain free death. One compliment from a relative stated, 'The family wish to express our sincere thanks to all the staff who cared for [person] and [staff] who looked after then with such kindness. Thank you also for the kind expression of sympathy and condolences which were a great comfort to us all.'

Skilled staff were provided with the necessary support including coaching, shadowing experienced staff and regular supervision, staff maintained their skills. People's needs were completely met. One relative told us of the significant difference staff made to their family member in being able to live at home. People's independence was upheld and promoted with enough to eat and drink. Staff enabled people to access healthcare support by working exceptionally well with others involved in people’s care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were cared for by staff with compassion, kindness and dignity. Staff knew people well and they promoted people’s privacy, culture needs and independence. People had a say and choice in who and how their care was provided. One person told us, "I absolutely can’t praise staff enough for what they do. They go the extra mile every time and do the little things that mean so much.”

The registered manager promoted and supported an honest and open staff team culture. Staff upheld the provider's values by helping people live a meaningful life. Governance and oversight of the quality of the service was highly effective in driving improvements which changed people's lives for the better. People were at the heart of determining how the service was run. The service and its management team worked extremely well and successfully with other organisations. People received care that was highly coordinated and as a result they led a meaningful life. Many people complimented the service for the quality of care provided. One relative told us that all staff had totally transformed their family member’s life and how pleased they were at how well the service was run.

Risks to people were identified and managed well. Appropriate steps had been taken to safeguard people. Sufficient numbers of staff with the required skills had been recruited safely and deployed to keep people safe. The provider’s monitoring systems were useful in alerting any reason staff were running late. One person spoke fondly of their care staff and said, “I feel safe knowing I can rely on [staff]. I have never ever had a missed [care] visit” People were supported to take their medicines as prescribed by trained and competent staff. Lessons were learned when things did not go quite so well. Infection control systems promoted good hygiene standards.

Rating at last inspection: Good (report published 03 December 2016). At the latest inspection the service had improved to outstanding.

Why we inspected: This was a planned inspection based on the previous rating.

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