Bramble Home Care Limited

Updated 14 September 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 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 that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 6 July 2023 and ended on 11 July 2023. We visited the location’s office/service on 6 July 2023 and 10 July 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. 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 information gathered as part of monitoring activity that took place on 14 December 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We spoke to 5 people who use the service and 10 people's relatives about their experience of the care provided. We spoke to the director of operations and business development, the owner of the business, the registered manager, the training coordinator, the field care supervisor and 7 care staff.

We reviewed a range of records. This included 7 people's care records and medication records. We looked at 5 staff files in relation to staff recruitment, training and support, and a verity of records relating to the management of the service.

Updated 14 September 2023

About the service

Bramble Home Care Limited is a domiciliary care service that provides personal care and support to people living in their own homes. The service supported 49 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.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person who received personal care. 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 improvements were needed to ensure people's risks were assessed and mitigated in areas such as diabetes, health appliances care and moving and handling tasks. Records relating to the assessment and management of people's risks required improvement to ensure staff had access to complete and up-to-date information to keep people healthy and safe.

We found that improvements were needed to the provider's quality monitoring systems and processes, including the monitoring of care call delivery and care records.

We did not find that these shortfalls had impacted on people's care. The provider had identified areas that required improvement through their own quality monitoring and had developed an improvement plan. However, further time was needed for the registered manager to embed and complete their improvement plan before we could judge it to be effective in bringing about the required improvements.

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 majority of people and relatives we spoke with told us they felt safe and cared for by the service.

Staff understood their responsibility to report concerns and poor practices. Staff knew how to report any incidents or accidents.

Staff understood their role to wear Personal Protective Equipment (PPE) in line with government guidance.

Systems were in place to engage with staff and people who use 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

The last rating for this service was good (published 21 December 2020).

Why we inspected

The inspection was prompted by concerns received in relation to the quality of care and the management of the service. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bramble Home Care Limited on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches of regulations in relation to safe care and treatment and 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.