4 July 2016
During a routine inspection
Bloomsbury Homecare – The Butterfield Centre provides care for people in their own homes. The service can provide care for adults of all ages. It can assist people who live with dementia or who have mental health needs. It can also support people who have a learning disability, special sensory needs, a physical disability or who misuse drugs and alcohol. At the time of our inspection the service was providing care for 310 people most of whom were older people. The service covered Stamford, the Deepings, Bourne, Spalding and Grantham and surrounding villages.
The service was previously registered to operate in Lincolnshire and provided care to a small number of people in their homes who lived in Spalding, Grantham and Lincoln. This service was run from an office that was not based in Lincolnshire. In late Autumn 2015 the service won a much larger contract with the local authority that involved it providing care to people in their homes in Stamford, the Deepings and Bourne. As a result of this development the company decided to open a new office in Bourne from which to administer the extended services it had been commissioned to provide in Lincolnshire. We registered this new arrangement on 29 January 2016 and this was our first inspection since that date.
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.
We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. This was because the registered persons had not always provided staff at the right time to safely care for people some of whom needed to be helped to use medicines. The procedure used to recruit new staff was not robust. Although most people had received the basic care they needed some people were not being reliably assisted to eat and drink enough to promote their good health. Furthermore, the registered persons had not always effectively resolved complaints. All of these problems resulted from the registered persons not operating a system of rigorous quality checks. A further shortfall involved the registered persons not telling us about significant events that had happened in the service and this had reduced our ability to make sure that people were kept safe. You can see what action we told the registered persons to take at the end of the full version of this report.
Possible risks to people’s health and safety had not been effectively managed and this had increased the risk that avoidable accidents would occur.
Some people who paid for the service on a private basis had not always been provided with bills that accurately reflected the service they had received and had been over-charged.
Some staff did not have all of the knowledge and skills they needed in order to care for people in the right way and the registered persons had not consistently provided staff with the guidance and training they needed.
The registered persons and staff were following the Mental Capacity Act 2005 (MCA). This measure is intended to ensure that people are supported to make decisions for themselves. When this is not possible the Act requires that decisions are taken in people’s best interests.
People were not always treated with kindness, compassion and respect.
People had not always been consulted about the care they wanted to receive. In addition, care was not always planned, delivered and assessed in a consistent way.
People had not been fully consulted about the development of the service and had not benefited from staff acting upon good practice guidance. However, the service was run in an open way and staff were able to speak out if they had any concerns about poor practice.