Background to this inspection
Updated
18 July 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was prompted in part by concerns raised from people and staff involved with this service. This inspection examined those risks which included staff not being adequately trained and staff working without a disclosure and barring check.
Inspection team: One inspector carried out this inspection.
Service and service type: Bloomsbury Worcestershire is a domiciliary agency caring for people in their own homes. At the time of our inspection a new manager had been appointed but they had not registered with the Care Quality Commission: A registered manager 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 48 hours’ notice of the inspection visit because it is small, and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
Inspection site visit activity started on 12 March 2019 and a follow up visit took place on 20 June 2019. We visited the office location on 13 March 2019 and 20 June 2019 to see the manager and office staff; and to review care records and policies and procedures.
What we did: We used information the provider sent to us in the Provider Information return (PIR). This is information we require providers to send to us at least once annually to give us some key information about the service, what the service does well and improvements they plan to make. We looked at information we held about the service, including notifications they had made to us about important events. We also reviewed all other information sent to us from other stakeholders, for example, the local authority and members of the public.
During the inspection, we spoke with 10 people using the service and one relative to ask about their experience of care. We spoke with the new manager and the nominated individual. We also spoke with the three team leaders and eight support staff.
We looked at the care records for five people, 16 staff employment related records and records relating to the quality and management of the service. Details are in the Key Questions below.
Updated
18 July 2019
About the service: Bloomsbury Worcestershire is a domiciliary care agency providing care for people in their own homes. At the time of the inspection there were 39 people using the service. There was not a registered manager in post at the time of our inspection. 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. However, the provider had recruited a new
manager who would be registering with us.
Not everyone using [Bloomsbury Worcestershire] receives a regulated activity; 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.
People’s experience of using this service:
• Staff recruitment records had been checked since our first day of inspection, so the provider could assure themselves people's safety was maintained because all staff were suitable to work with people in their homes.
• People were not always supported by staff who were appropriately trained.
• Staff were now provided with regular supervision to do their job effectively.
• The provider lacked robust and effective systems and processes to ensure the quality and safety of service.
• People and relatives told us staff were not always caring and didn’t always respect their right to confidentiality.
• People's needs were assessed before they started receiving care and they told us their needs were met.
• 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 involved in the care planning process, but reviews were not always carried out regularly.
• People's independence was encouraged and maintained.
• People and relatives knew how to raise concerns.
Rating at last inspection: The provider was called Bloomsbury West Midlands and was rated Good on 15 October 2015. The provider moved offices to Worcester and changed their name to Bloomsbury Worcester.
Why we inspected: This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received. We had received a number of complaints from people using the service and whistle-blowers.
This is the first time this service has been rated Requires Improvement.
Enforcement:
At our first day inspection on the 12 March 2019 we identified concerns regarding staffing, staff recruitment and the provider's quality assurances systems. When we returned to the site on the 20 June 2019 we found the necessary improvements had been made, However, we found the work to improve the service was still ongoing and further time was required to evidence the improvements could be sustained in the longer term which we have reflected in the ratings.
Follow up:
We will work with the provider following this report being published to understand and monitor how they will make changes to ensure the service improves their rating to at least Good.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk