Bowtree Homecare Ltd

Updated 31 August 2023

The inspection

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 an inspector and a regulatory coordinator.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 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.

Inspection activity started on 19 July 2023 and ended on 24 July 2023 when we provided feedback remotely. We visited the location’s office on 19 July 2023.

What we did before the inspection

We reviewed information we had received about the service since it was registered with CQC. We used information gathered as part of monitoring activity that took place on 20 March 2023 to help plan the inspection and inform our judgements. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

With their consent, we spoke with 3 people using the service and 3 relatives. We also spoke to 5 members of staff including the registered manager, care coordinator and care workers. We looked at a range of records. This included 2 staff recruitment files, records relating to medicines, training and supervisions, care records and policies and procedures.

Updated 31 August 2023

About the service

Bowtree Homecare Ltd is a domiciliary care agency registered to provide personal care to people in their own homes. At the time of our inspection there were 8 people receiving support with personal care. 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

The service was appropriately staffed, though recruitment practices needed improving, the provider was working on making the necessary changes. People told us they felt safe and medicines were managed appropriately. There were some improvements that could be made around risk management and the provider was receptive to this. Infection control practices were safe, and we were able to see evidence of lessons learned though how this was shared with staff was not clear.

Staff received supervision but they were not regular. The registered manager implemented a tracker to ensure appropriate oversight. Staff training compliance rates needed to be improved. The registered manager told us they would ensure training compliance was improved. Peoples needs were assessed before starting with the service and people were appropriately supported with eating and drinking. When needed, people were supported with their healthcare and the serviced worked in partnership with various healthcare professionals.

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.

Equality and diversity was respected, care staff were kind and considerate and people provided positive feedback about carers and the service. People’s independence was supported, and confidential information was stored securely. People were supported to share their views.

People received person centred care and people provided positive feedback about their care. Some elements of people’s care plans would benefit from further information adding. People’s communication needs were being met and any complaints were handled appropriately. No one was receiving end of life care at the time of the inspection.

Various quality assurance systems were in place, but these needed to be more robust. Staff meetings were taking place and people had completed surveys about their care. The service had a positive culture and people, their relatives and staff spoke positively about the management. The registered manager was aware of their regulatory responsibilities and spoke about being open and honest when things go wrong.

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

This service was registered with us on 25 October 2021 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We have identified breaches in relation to recruitment and good governance.

Please see the action we have told the provider to take at the end of this report.

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.