B & H Care

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

The inspection was undertaken by 1 inspector.

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

This inspection was unannounced.

Inspection activity started on 11 April 2023 and ended on 28 April 2023. We visited the location’s office on 11 April 2023.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We reviewed information we had received about the service since registration. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

During our visit to the service’s office, we spoke with the registered manager and care coordinator, we also spoke briefly with a member of the office staff, the relative of a person who used the service and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also reviewed 8 staff personnel records, cards received by the service thanking them for the care and support provided and we were shown how the system is used to manage and plan visits to people using the service.

Following our visit we reviewed 6 people’s care records, medicine records, staff training records and records relating to governance such as audits, policies and procedures, and complaints.

We received electronic feedback from 1 person using the service, 4 people’s relatives, 11 staff and 3 social care professionals. We also spoke with 8 people who used the service and 9 relatives on the telephone.

We fed back the findings of our inspection on a video call to the registered manager and nominated individual on 28 April 2023.

Updated 3 June 2023

About the service

B & H Care is a domiciliary care service providing personal care to adult people living in their own homes. 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. At the time of our inspection there were 52 people receiving personal care support.

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

Right Support:

People received their medicines, as required. Auditing supported the provider to identify and address shortfalls.

People’s independence was respected. People and their representatives were involved in care planning and reviews.

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.

Right Care:

People’s care records were not always person centred and identified how people’s needs were to be met and risks mitigated. This was a risk of people receiving inappropriate care. We have recommended the provider include guidance for staff in care records to ensure they understood the signs and indicators of risks with people’s care and when to report concerns.

We received concerns about all staff not understanding how to support people with the preparations of their meals. We were assured the provider was taking action to improve, such as providing cultural training to staff.

We received feedback from people and relatives that people’s privacy and rights were respected and they were provided with a caring service. Staff were trained in safeguarding and systems helped to reduce the risk of abuse.

Right Culture:

The governance systems in place required improvement to ensure that the provider is able to independently identify shortfalls and address them. This included recording and oversight of the timings of care visits.

Improvements were needed in how the service monitored and addressed the times of people’s scheduled visits. We received feedback from some people that they often felt rushed by staff and they were not always staying for the planned amount of times for their visits. We had received feedback from a person who used the service which identified when they had raised a concern with a staff member, this was not responded to in an appropriate way. There was ongoing staff recruitment and staff were recruited safely. Staff received an induction and training to meet people’s needs.

People were asked for their views on the service and their comments were valued. There was a complaints procedure and records showed people’s complaints were investigated and addressed.

We received positive feedback about the registered manager and how they led the service.

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 9 September 2022 under the current location address. This is the first inspection of this service. The last rating for this service under the previous location address was requires improvement (published 22 June 2022).

Why we inspected

This comprehensive inspection was undertaken, because as a newly registered service, they had not yet received a rating. Prior to the inspection, concerns were received about medicines, people’s care records and governance. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to person centred care, staff deployment and 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.