Blessing's Care

Updated 14 November 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 homes.

This service also provides care and support to people living in 7 ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

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. The registered manager and nominated individual were also the provider and both were involved in the day to day running of the service. The nominated individual is usually responsible for supervising the management of the service on behalf of the provider.

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 28 September 2023 and ended on 12 October 2023. We visited the location’s office on 28 September 2023 and 12 October 2023. Two Experts by Experience made phone calls to people and their relatives on 29 September 2023.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 9 people and 9 relatives of people who received support for feedback on their experience of the care provided. We spoke with the registered manager and nominated individual. We spoke with the care co-ordinators, property manager, supported living manager and office staff. We received feedback from 19 senior care staff and care staff.

We reviewed a range of records. This included 7 people’s care records and multiple medicine records. We looked at 3 files in relation to staff recruitment and support. We looked at a variety of records relating to the management and running of the service.

Updated 14 November 2023

About the service

Blessing’s Care is a domiciliary care service providing the regulated activity of personal care to people in their own homes. Not everyone who used the service received personal care. At the time of our inspection there were 67 people receiving support in their own homes.

Blessing’s Care also provide the regulated activity of personal care to people living in 7 supported living houses. At the time of inspection 1 person in 1 of the houses received support with 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 provide personal care to 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:

Medicines processes were not always safe. Improvements were needed to the information available to staff to safely support people who may show behaviour indicating distress.

Recruitment processes were followed but there were no risk assessments in place if there were any delays with any recruitment checks.

Known risks to people’s care were assessed and reviewed. People felt safe with the care they received from staff. Staff were reliable and stayed to complete all required tasks. Staff used personal protective equipment (PPE) when providing personal care. Accidents, incidents and falls were reported and followed up.

Right Care:

People received personalised care which was responsive to their needs. Staff knew people’s care needs and how to meet them. People’s communication needs were assessed and recorded.

Complaints were taken seriously and there was a complaints procedure in place. People and relatives knew who to contact if they had any concerns and confirmed issues were resolved.

No-one was receiving end of life care at the time of inspection. Information was recorded if people had made a decision about DNACPR (Do not attempt cardio-pulmonary resuscitation).

Right Culture:

Quality assurance systems were not always effective at supporting staff to identify and take action about areas which needed improvement. This meant the provider did not have effective oversight of key areas of the service. Notifications to external agencies including the local authority and CQC about serious incidents or safeguarding concerns were not always made in a timely manner.

The provider was committed to ensuring people received good quality care and were receptive to the inspection process and all suggestions for improvement offered.

Systems to support staff through supervision and team meetings were being embedded into practice. Feedback was sought from people informally and through the use of surveys.

The staff team worked well with health and social care professionals involved in people’s care and treatment. The majority of staff provided positive feedback about working for the service and the quality of care given to people.

The provider responded immediately to concerns found during the inspection. They took prompt action and began to implement improvements straight away.

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

Rating at last inspection and update

The last rating for this service was good (published 11 September 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. 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 report.

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

Enforcement

We have identified breaches in relation to people’s safe care and treatment and governance arrangements 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.