Archived: Bridgewater Home Care

Bridgewater Home Care provides domiciliary care and support for people in their own homes, predominantly in the Wigan area. The head office is based at Pemberton Business Centre. At the time of the inspection there were 75 people using the service.

There was a registered manager in post. 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 people we spoke with told us they felt safe. The staff we spoke with had a good understanding about safeguarding and whistleblowing procedures and told us they wouldn’t hesitate to report concerns.

We found medication was handled safely and people received their medicines at the times they needed it. We looked at how medication was handled at two of the houses we visited. Staff told us they had received relevant training and management conducted regular competency checks, to ensure staff gave people their medication safely.

The service used a call monitoring system. This enabled management and staff in the office to check care was being provided to people at the correct time of day and in line with people’s care package requirements. Staff spoken with didn’t raise any concerns about staffing numbers, and felt there were enough to care for people safely.

We saw staff were recruited safely, with appropriate checks undertaken before staff began working with vulnerable adults.

The service had a training matrix to monitor the training requirements of staff. This showed us staff were trained in core subjects such as; safeguarding, moving and handling, medication and health and safety. Staff told us they received sufficient training to undertake their roles and said they felt supported.

People told us staff helped them to maintain good nutrition and hydration. People said staff always left them with something to eat and drink before leaving their house.

We saw staff received regular supervision as part of their on-going development. This provided an opportunity to discuss their workload, concerns and training opportunities. We saw records were maintained to show these took place.

The people we spoke with told us they were happy with the care provided by the service. People told us staff treated them with dignity and respect and promoted their independence as much as possible.

Each person who used the service had a care plan with a copy held at the office and in their own home. This provided staff with guidance about how to deliver care to people. The care plans we looked at were person centred and provided information about people’s likes, dislikes and life histories.

The service sent satisfaction surveys to people who used the service. This provided the opportunity for people to provide feedback about the service and recommend how the service could be improved.

There was a complaints procedure in place. We saw complaints were responded to appropriately. People were given a service user guide which detailed the process people could follow if they were unhappy with the service. We saw the service had received many compliments from people regarding the services they received.

People who used the service and staff told us they felt the service was well managed, Staff told us they felt well supported and would feel comfortable raising and discussing concerns.

We saw there were systems in place to monitor the quality of the service provided. This was done in the form of regular spot checks and observations of staff undertaking their work. We saw medication competency assessments were conducted. This provided management the opportunity to see how staff worked and make adjustments/suggestions to improve the service people received.

We talked with three staff, four people who used the service, the registered manager and with the director who is closely involved in running the business.We looked at care files, staff files and other records.

We considered all the evidence we had gathered and used it to answer five key questions:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

Is the service safe?

All the information we gained about people using the service suggested that they were happy with the service provided and felt safe with the carers. The staff we spoke with were trained in safe handling techniques and the safe administration of medicines. They knew what signs of abuse to look out for, and they told us they would immediately report any evidence or suspicion of abuse. Where staff had concerns about the safety or welfare of the person they supported we found they had raised their concerns through the correct channels.

We found that the arrangements for handling medicines were safe. Medicines were only administered by suitably trained care workers. Individual support plans were in place describing people's medicine's needs however, on occasion these were in need of review. The manager told us they would look at this as a priority.

Is the service effective?

People using the service had sent in letters and replied to questionnaires, saying that they were pleased with the service and it was meeting their needs. The staff rota system worked effectively and people we spoke with told us the staff were always on time. People told us they were happy with their carers because they knew what they needed and were satisfied that they had the same carers.

Is the service caring?

Staff we met talked about the people they supported affectionately and with respect. People told us that they felt well cared for. We observed positive relationships between staff and people using services and the ethos and culture within the agency was person centred and promoted people's independence.

Is the service responsive?

During our inspection we observed the manager responding appropriately to a concern someone had raised. It was done in a timely manner and consideration was given to the negative impact on the person if they did not respond immediately. The manager knew people well and was able to respond appropriately when the need arose. Staff we spoke with knew and understood the individual needs of the people they supported and knew what to do if their care needs changed.

Is the service well led?

The registered manager and the director worked closely together and as a team. Regular meetings took place between the director and the manager and the manager and senior staff. This meant information was shared within the agency in order to improve services for people who used the service as well as staff morale. Senior carers had recently been appointed which would enable the manager to delegate responsibility as and when the business grew. The manager was accessible to staff and encouraged openness and honesty within the team.

At this inspection we found that the majority of staff members had received updated training in medicines management. However, we also found issues of continued non compliance in this area.

Additionally, we also found that records had not been accurately reviewed and not all were available at the inspection.

We identified an area of care and support that requires improvement and this is referred to within the body of this report. In addition the provider has also identified some improvements and are taking steps to ensure that these are made.

We spoke with three people who used the service, two relatives and two members of staff.

Overall people who we spoke with were very satisfied with the service provided. However, one person who used the service, although they were more than satisfied with the care and support found the charges were becoming too expensive. The provider has since told us that the charges for their services have not increased since the company started in October 2010.

We were told comments such as ''We like and appreciate the continuity of a consistent team''. '' I am very pleased with the service for my relative''. ''The care is very good but their cooking could be better'' and ''The staff are very friendly and mainly on time. Very occasionally they are delayed but they always let me know''.

Their comments were very positive and everyone agreed that they liked the service provided. They used words to describe it such as

'' I feel that the staff are well matched to meet mothers needs and personality''

'' The staff are very willing and adaptable, helpful and caring. The girls work together as a team with my mum and the family''

We asked people if there was anything that they would change about the service. Care staff wore disposable aprons and gloves when providing personal care one relative suggested that it would be nice if a protective tabard was worn routinely. People expressed a lot of confidence in the staff and the manager and felt that they had no problems.

Everyone spoken with knew how to access staff, the manager and how to make a complaint.

One relative told us that when they were present at the same time as staff they were always respectful to their mother and treated her with dignity.

We found that documentation showed that staff followed company procedures and that the daily visit sheets were signed by the staff member and their relatives or the person using the service when appropriate.

We contacted the quality monitoring team from the local social services department. They stated that they had no concerns about this service provider.

Since the inspection was carried out a new manager has taken up post and is currently going through the registration process with C.Q.C.