Blessing's Care

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.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older and younger adults and people with disabilities.

Not everyone using Blessing's Care Ltd Domiciliary Care receives 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.

A registered manager was 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.’

People were protected from the risk of harm. Staff had been trained in safeguarding people and understood how to report any concerns of abuse. Risks to people’s safety were assessed to ensure preventative action was taken to reduce the risk of harm to people.

People were supported with their medicines in a safe way. People’s nutritional needs were met and they were supported with their health care needs when required. The service worked with other organisations to ensure that people received coordinated care and support.

People were protected by safe recruitment procedures to ensure staff were suitable to work in care services. There were enough staff to meet people's needs. Staff received training for their role and ongoing support and supervision to work effectively.

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. The provider, manager and staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA) and gained people's consent before they were supported.

People were involved all aspects of their care. People’s care plans information available about people’s preferences, daily routines and diverse cultural needs. Staff had a good understanding of people's needs and preferences and worked flexibly to ensure they were met.

People and their relatives were happy with staff who provided their personal care and had developed positive trusting relationships. People were treated with dignity and respect, and their rights to privacy were upheld.

People, relatives and staff were encouraged to provide feedback about the service and this was used to drive continuous improvement. People and relatives all spoke positively about the staff team and how the service was managed. The provider had a process in place which ensured people could raise any complaints or concerns.

The registered manager and staff team were committed to following the vision and values of the service in providing good quality care. The registered manager was aware of their legal responsibilities and provided effective leadership and support to staff. Quality assurance systems were used to monitor and assess the quality of the service to drive continuous improvement. The provider worked in partnership with other agencies to meet people’s needs.