Bramble Home Care LTD - Cinderford

Updated 3 June 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

This inspection was carried out by 2 inspectors and 2 Experts 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.

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 48 hours' notice of the inspection. This was because we needed to be sure the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 04 April 2023 and ended on 11 April 2023. We visited the location's office/service on 04 and 05 April 2023.

What we did before the inspection

We reviewed information we had received about the service since its registration. We sought feedback from the local authority. 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

We spoke with 13 people who used the service and 21 relatives about their experience of the care provided. We spoke with a senior care assistant, 11 care assistants, the care coordinator, the service development lead, the trainer, the registered manager, the nominated individual, and the owner of the service.

The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 6 people's care records and multiple medication records. We looked at 6 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

We received feedback from 4 health and social care professionals working with the service.

Updated 3 June 2023

About the service

Bramble Home Care LTD - Cinderford is a domiciliary care service that provides personal care and support to people living in their own homes. The service supported 62 people who received personal care at the time of the inspection.

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.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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

We found some improvements were needed to ensure people’s care documentation and medicines records were accurate, complete and contemporaneous. Staff understood people's risks and how to keep them safe, but people's care records were not always up to date with the necessary information. The provider's audits were not always fully effective in identifying and addressing quality and safety concerns related to care and medicine records.

We did not find these shortfalls had impacted on people's care and the registered manager responded to our inspection feedback and was open to making improvements to the service.

People and their relatives were complimentary about the service provided by Bramble Home Care LTD - Cinderford. They were positive about the caring nature and approach of staff. They felt safe when staff visited and were confident concerns would be dealt with.

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 received care and support from a consistent group of staff who had been trained and supported to meet their needs. Staff spoke positively about the support they received and how this promoted person centred care.

Comments from people and their relatives regarding the care and support they received from the service included, “They are excellent. The girls are a lovely lot.”; “We are very happy with the care; they are lovely people.” and “Very good. They are all angels.”

Infection prevention measures had been established and implemented. Staff had a good understanding of these procedures.

Systems were in place for people to raise concerns and for the registered manager to receive feedback from people who used the service. This enabled them to monitor the quality of the service being provided to people

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 01 April 2022 and this is the first inspection.

Why we inspected

We carried out an announced comprehensive inspection of this service on 04 and 05 April 2023. This was a planned inspection based on the service being newly registered.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach of regulation in relation to good governance at this inspection.

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.