Bucks Country Home Care Limited

Updated 30 April 2021

The inspection

We carried out this focused 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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 15 April 2021 and ended on 21 April 2021. We visited the office location on 15 April 2021.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. Throughout the inspection we gave the provider opportunities to share with us what they did well. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used all this information to plan our inspection.

During the inspection

We made contact with five people who use the service and received feedback from four. We received feedback via our online portal from four relatives. We spoke with three members of staff including the registered manager and two care managers all who were based in the office.

We reviewed a range of records. This included five people’s care records and six people’s medicine records. We looked at three staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We requested feedback from four health and social care professionals and six staff. We received feedback from four people via our online portal and four staff.

Updated 30 April 2021

About the service

Bucks Country Home Care Limited is registered to provide personal care and support to people in their own homes. 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 service supported 54 people across rural Buckinghamshire.

People’s experience of using this service and what we found

People and their relatives gave us positive feedback about the care and support received. Comments included, “Always polite, caring and professional” and “The carers that come to the house, all provide outstanding, compassionate care calls”.

At the last inspection we found people were not routinely supported with their prescribed medicines in a safe manner, systems in place to manage medicines were not effective. Since the last inspection improvements have been made and we found people received their medicines when needed. This was corroborated by a relative who told us “The carers administer his medication professionally at the appropriate times.” We have identified the service would benefit from further improvements in records relating to medicines prescribed for occasional use. The registered manager is aware and has plans in place to ensure this is completed.

People who were at risk of potential harm as a result of their medical conditions, environment, or ability to move had risk assessments in place. However, we found some risk assessments could have provided more detail to staff on how to mitigate harm. We have made a recommendation about risk management records.

People were supported by staff who had been recruited safely, had received support and training for their role. Staff had their competency checked to ensure they had the right skills and knowledge to work with people.

The provider ensured staff and people were protected from the risk of infections. Staff had access to good supplies of personal protective equipment (PPE), and people confirmed this was used on a regular basis. Additional infection control training had been provided following the Covid- 19 outbreak.

People and their relatives told us they found the service responsive to their needs. They commented they received a good service and knew who to contact about their care needs. Comments included, “Taking into consideration this unprecedented year of Covid-19, this service has been excellent” and “The office in Longwick is adept at changing the programme at short notice if I have to ask them to do so.” Another person told us “Someone is always available via telephone.” A relative told us they were “Very pleased with all that they do, very reliable always very helpful.”

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 requires improvement (published 22 November 2019).

Why we inspected

We carried out an announced comprehensive inspection of this service on 22 and 25 October 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment in respect of medicine management.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.