Archived: Qura Brain Injury Service

Updated 30 September 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 on 3 and 19 August 2015 and was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service. We needed to be sure that someone would be available. The inspection team consisted of one inspector and an expert 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.

We reviewed a range of records about people’s care, support and how the domiciliary care agency was managed. These included care records for three people, medicine administration records (MAR) sheets incident reports and other records relating to the management of the domiciliary care agency. These included three staff training, support and employment records, quality assurance audits and a range of policies and procedures used by the service.

We spoke with the registered manager, a senior manager and three care coordinators. In addition we carried out telephone interviews with twelve people who used the service. Ten staff were sent questionnaires. We contacted six professionals who work with the agency including a clinical neuropsychologist, district nurse, social worker, clinical facilitator and community psychiatric nurse. We received two responses.

Updated 30 September 2015

Qura Brain Injury Service is a domiciliary care agency which provides support to people with complex and continuing care needs, specifically for brain acquired injury and other neurological disorders. The agency is one part of a larger organisation called Active Assistance. Qura Brain Injury Service provides services in the South West of England. At the time of this inspection Qura Brain Injury Service was providing support for approximately 70 people.

This inspection took place on 3 and 19 July 2015. The inspection visit was announced 24 hours in advance in accordance with the Care Quality Commission’s current procedures for inspecting domiciliary care services. The service was previously inspected in July 2014 when it was found to comply with the requirements of regulations.

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.

The majority of people told us they had not had to use the on call numbers to speak with staff out of hours. However some people who had needed to use the out of hours service told us nobody had answered the phone, even though they had been provided with more than one number to ring.

Staff had a full understanding of the specialist care and support people required. Training and support for staff was happening on a regular basis and focused on the specialist needs of people using the agency. As well as providing care and support to people staff also supported people to develop social skills to engage in community activities. For example going to exercise classes, visiting the cinema.

People told us they felt safe and secure when receiving care. People received consistent support from care workers who knew them well. However some people told us they did not always receive care and support from regular carers. One person said, “ With my regular carers I do feel safe but it is when they use agency staff, I get a different one every time and I feel really tired having to explain every time what needs doing”.

Most staff told us they were supported by senior staff including the registered manager. Staff said, “I have every opportunity to speak with my manager on a regular basis and feel confident I am listened to”. One staff member however felt recent changes within the senior staff team meant communication was not as good as it had been and some things might get missed.

Recruitment systems were robust and actively encouraged people using the service to take an active role in the selection process of their personal carers. This helped ensure people received care and support from staff who were competent and well matched to the role.

Audit systems were in place to monitor and manage how care and support was being delivered took account of accidents and incidents, as well concerns and complaints. The systems in place acted as early indicators of themes or trends which might affect individuals using the service or staff supporting people.

The registered manager demonstrated a good understanding of the importance of effective quality assurance systems. A review of the processes to monitor quality and understand the experiences of people who used the service was taking place, to include specific information about the needs of people with brain acquired injury or other neurological conditions. Some people told us they had not been asked for their views about the service.

The registered manager demonstrated strong values and a desire to learn about and implement best practice throughout the service.