The inspection was unannounced and took place on the 18 December 2014. An arranged visit to complete the inspection was then undertaken on the 22 December 2014.
The last inspection took place on the 24 July 2013 when Prestbury Beaumont Domiciliary Care Agency [DCA] was found to be meeting all the regulatory requirements looked at and which applied to this kind of service.
Barchester Prestbury Beaumont DCA is located one mile outside Prestbury Town Centre. This Domiciliary Care Service is managed from Prestbury Beaumont Care Home, which is on the same site. The DCA service is provided to people in the fourteen bungalows and nine apartments owned by the people themselves.
Prestbury Beaumont DCA 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. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The provider had appointed a new management team with responsibility for the DCA and Prestbury Beaumont care home approximately six months before this inspection visit. As part of this re-structure a new home manager was appointed in May 2014, she is also the registered manager for the DCA.
New systems such as the arrangement of regular resident/relative meetings and a manager’s surgery had been put into place. The meetings and surgeries enabled people to discuss any issues.
At the time of the inspection six people living in the bungalows and apartments were receiving a service from the agency. Many of the services provided to the people living in these were from staff and resources within the home. For example meals could be prepared and served in the home and people could join in with any social activities organised. The ‘Independent Living’ accommodation also has an emergency call system so that the people living in them could summon assistance if needed.
Since the previous inspection the care home had undergone a refurbishment and the lounge and dining areas that can be used by the people living in the bungalows and apartments had been re-furnished and redecorated. In addition a new Spa providing a range of treatments such as manicures and a hydro pool had been built and had opened approximately two weeks before the inspection took place. This can be used by the people living in the independent living accommodation. One person using the DCA told us, “it is the best of all worlds. I can spend time in the home [care home]. The care is great – so well cared for. The best move I ever made”.
We saw that the service had a safeguarding procedure in place. This was designed to ensure that any possible problems that arose were dealt with openly and people were protected from possible harm.
There had been no new staff members specifically employed to work in the DCA so we looked at the files for the three most recently appointed staff members who were employed to work in the care home to check that effective recruitment procedures had been completed. We found that the appropriate checks had been made to ensure that they were suitable to work with vulnerable adults.
The provider had their own induction training programme that was designed to ensure any new staff members had the skills they needed to do their jobs effectively and competently.
We asked two staff members working in the DCA about training and they both confirmed that they received regular training throughout the year and that it was up to date.
The service had a range of policies and procedures which helped staff refer to good practice and included guidance on the Mental Capacity Act 2005. This meant that the staff members were aware of people's rights to make their own decisions.
We saw that the relationships between the people using the service and the staff employed were warm and respectful.
The care plans were reviewed when needed so staff knew what changes in care provision, if any, had been made. The two care plans which the service called, assisted living care profiles we looked at all explained what each person’s care needs were. This helped to ensure that people’s needs continued to be met.
Staff members we spoke with were positive about how the agency was being managed. The staff members we spoke with were positive about the service and the quality of the support being provided.
The provider, Barchester also had its own monthly internal clinical governance system into which the registered manager had to submit monthly information based on the audits undertaken within the agency to the company’s head office. This included, care plans, accidents, incidents, safeguarding allegations and complaints.