Better Home Care

Updated 16 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place between the 19 and 20 April 2018 and was announced.

The inspection was undertaken by one inspector. We gave the provider 48 hours' notice as the service is small and we needed to be sure they were in. This was also because some of the people using the service could not consent to a home visit or phone call from an inspector, which meant that we had to make alternative arrangements about this.

Before the inspection the provider completed a Provider Information Return (PIR). This is information we require providers to send us at least annually. This provides us with information about the service, what the service does well and improvements they plan to make. We used this information to assist us with the planning of this inspection. We also looked at other information we held about the service. This included information from notifications the provider sent to us. A notification is information about important events which the provider is required to send to us by law such as incidents or allegations of harm.

Prior to our inspection we contacted organisations to ask them about their views of the service. These were the local safeguarding authority and commissioners of the service. These organisations’ views helped us to plan our inspection.

On the 19 April 2018 we visited the provider’s office and we spoke with the registered manager, two care staff and two relatives. On 20 April 2018 we spoke with five people and a further five relatives by telephone.

We looked at care documentation for four people using the service at Better Home Care and their medicines’ administration records. We also looked at two staff files, staff training and supervision planning records and other records relating to the management of the service. These included records associated with audit and quality assurance.

Updated 16 May 2018

Better Home Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It is registered to provide a service to older people, people living with dementia and people with mental health needs. Not everyone using Better Home Care received a regulated activity; the Care Quality Commission (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.

This inspection was carried out between 19 and 20 April 2018 and was an announced inspection. This is the first inspection of this service under its current registration. At the time of our inspection there were 32 people using the service.

The service had a registered manager. 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 received a safe service. Staff understood what keeping people safe meant as well as to whom they could report any concerns. An effective response to accidents and incidents helped reduce the potential for any recurrence. Only those staff deemed to be suitable following their pre-employment checks that had established their good character were offered employment at the service. There was a sufficient number of staff in post who had the skills and training they needed to provide people with safe care and support. People’s medicines were administered and managed safely.

People received an effective service that took account of their independence. People's wishes and preferences were respected by staff who knew what decisions each person could make and how to help people make these. People’s care and support plans were an accurate record of their individual needs and any assistance they required from staff. Risks to people were identified, and plans were put into place to promote people’s safety without limiting people’s right to choose what they wanted to do. 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.

Staff benefitted from the support, training and mentoring they were provided with and this helped to promote people’s safety and wellbeing. Staff understood their roles and responsibilities in meeting people’s needs. Systems, including regular spot checks, were in place to help staff to maintain their skills and the standard of work expected from them by the registered manager. People were supported to maintain their health by staff who enabled or supported them to access community or other primary health care services. Staff assisted people to eat and drink well.

People received a caring service. People’s care was provided with compassion by staff who promoted privacy and dignity. People were cared for with respect by staff who did this in an unhurried and considerate manner. People's independence was promoted by staff who encouraged people to make their own decisions about their care. People were provided with information about advocacy services if they needed someone to speak up for them.

People received a responsive service that helped them to have their needs met in a person centred way. Suggestions and concerns were acted upon before they became a complaint. Systems were in place to support people to have a dignified death.

People received a well-led service. Staff had various opportunities including meetings to feedback their experiences and receive updates about the service. Staff were provided with opportunities to develop their skills and the registered manager promoted openness so that people’s care was as good as it could be. Staff were supported in their role by the registered manager who listened to what staff said and then put the most appropriate support arrangements in place for each staff member.

Quality assurance, audit and governance systems that were in place were effective in identifying opportunities for improvements. The registered manager was proactive in implementing any actions that were required. People who used the service and their relatives were encouraged to share their views and feedback about the quality of the care and support provided. Their views were listened to, considered and acted upon.

Further information is in the detailed findings below.