Archived: Barnfield Care Agency

Updated 28 December 2019

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 Care Act 2014.

Inspection team

On 11 November 2019, two inspectors carried out this inspection.

Service and service type

Barnfield Care Agency provides a domiciliary care service to people in their own homes. CQC regulates the personal care provided.

The service had a manager registered with the Care Quality Commission. The registered manager was also the provider. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. The registered manager was given 48 hours' notice because they provide care and support to people in their own homes. We needed to be sure that someone would be available at the office to speak with us.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This includes statutory notifications sent to us by the provider and information from members of the public, other health agencies and the local authority and commissioners of care.

The provider had sent a provider information return (PIR) prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

Inspection site visit activity started on 11 October 2019 and was concluded on 18 November 2019.

On 11 November 2019 we visited the office location to speak with the registered manager, a care deputy manager and four care staff (the care staff and the registered manager provided care to people). We reviewed a range of records. This included examples of care records, daily records and medicines records. We reviewed a variety of records relating to the management of the service such as audits, staff recruitment files, complaints, compliments and people’s overall feedback about the service.

Following the inspection

We spoke on the telephone with eight people and four relatives to ask them to tell us about their experiences of using this service. Their feedback forms our judgements within this report.

Updated 28 December 2019

About the service

Barnfield Care Agency is registered to provide personal care to people living in their own homes, including older people who have a physical disability or people living with dementia.

At the time of our visit the agency supported 69 people, of which 56 people received personal care. CQC only inspects where people receive personal care. This is to help with tasks related to personal hygiene and eating. Where they do provide personal care, staff also consider any wider social care provided. Care calls ranged from 30-minute duration and at the time of our visit, 13 people received care, 24 hours a day, seven days a week.

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

The registered manager worked closely with staff and provided direct care to people themselves which gave them oversight of the service. However, there were limited systems in place to monitor and improve the delivery of the service. The registered manager said they checked daily records and medicine records, yet they failed to identify the issues we found. Furthermore, there were no records to show what actions had been taken when improvements were identified.

Care staff had not been recruited safely because the registered manager had not ensured all the required employment checks had been undertaken before staff commenced work at the service. These checks are required to ensure staff were suitable for their role.

Care plans and risk assessments reviewed were incomplete and did not provide staff with information to give consistent support. In some cases, certain health conditions although known by staff, were not recorded to form people’s plans of care.

Overall, people were happy and satisfied with the quality of care they received from a consistent care staff team. No one raised any complaints to us during this inspection visit although some relatives felt the management of the service could be improved. People were happy with the care provided and felt safe when being supported by staff. Staff knowledge of people helped to keep them safe from potential risk of harm or unsafe practice. Staff wore gloves and aprons to ensure they protected people from cross infection.

People and their relatives made decisions about their care and were supported by staff who understood and followed the principles of the Mental Capacity Act 2005. 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.

The provider was embracing new technologies such as electronic call monitoring. This was being set up and trialled before its eventual rollout. Other communication systems were used to inform and update care staff. However, we recommended that the registered manager seek guidance to ensure that confidentiality and security was not compromised through their use of some electronic communication systems.

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

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 Good (published 12 May 2017).

Why we inspected

This was a planned and announced inspection based on the rating at the last inspection.

Enforcement

We have identified two breaches in relation to safe care and treatment and the lack of effective monitoring of the quality of the service. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan from the provider to tell us what they will do to improve the standards of quality monitoring and safety. We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.