Betna Agencies Ltd

Updated 9 April 2022

The inspection

We carried out this 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

This inspection was completed by two inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing in Nottingham. There were two registered managers at the time of this inspection. One was also the nominated individual and provider. The nominated individual is responsible for supervising the management of the service on behalf of the provider. Both registered managers 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 one day's notice of the inspection. This was because the inspection was conducted during the COVID-19 pandemic and we wanted to speak with people and their relatives and care staff; we needed to be sure that the registered managers would be in the office to support the inspection.

Inspection activity started on 11 February 2022 and ended on 17 February 2022. Phone calls were made to people and their relatives and staff on 11 February 2022. We visited the office location on 14 February 2022. We continued to review evidence the registered manager sent us until the 17 February.

What we did before the inspection

We used information received about the service since the last inspection. We contacted local stakeholders to gather feedback on the care provided. This included the local authority commissioning team. On the 11 February 2022 we made phone calls to two people who used the service and three relatives to gather feedback about the care provided. We made telephone calls and spoke with three care staff.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We reviewed a range of records including the relevant sections of five people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. We reviewed other records related to the management of the service, including policies, training records and action plans.

We spoke with five members of staff, including both registered managers and three care staff.

What we did after the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 9 April 2022

About the service

Betna Care Agency Ltd is a domiciliary care service. It provides care for people living in their own houses and flats. People are supported in their own homes so that they can live as independently as possible. CQC regulates the personal care and support. There were 31 people who received personal care at the time of the inspection. 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.

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

Some improvements had been made since our last inspection to the provider's governance and oversight and some were still required. Records for medicines administration and governance and oversight arrangements were not always fully complete. The provider’s policy framework was up to date and comprehensive, however not always fully embedded and followed. Audits had been introduced and had resulted in some improvements, however some audits still needed to be more robust to identify all shortfalls and continue to drive forward improvements.

Care plans and risk assessments were in place to help reduce risks and promote safe care for people. Systems kept people safe from the risk of abuse and avoidable harm. Risks from infection transmission, including COVID-19, were risk assessed and actions in place to reduce risks. Recruitment processes were followed to check staff were suitable to work with vulnerable people. There were enough staff to meet people’s needs.

Assessment processes helped to inform people’s care plans. These included advice and guidance from other health and social care professionals to help provide people with effective care. Staff were provided with training relevant to people’s health and care needs. People were supported with relevant nutritional support where this was part of their care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People received care from friendly and caring staff. Staff understood how to promote people’s independence and respect their privacy and dignity. People’s equality and diversity needs were respected. People were listened to and involved in their care decisions.

People received personalised care and their choices were respected so they retained control over their lives. Staff knew the people they cared for and provided responsive care. People were supported with any communication needs they may have. Care was provided in a way that helped to reduce social isolation and promoted people’s relationships with others. People were able to provide feedback or raise complaints and have them investigated and resolved.

At this inspection, we found improvements had been made and the provider was no longer in breach of regulation 12 (Safe care and treatment), regulation 19 (Fit and proper persons employed) and regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At the last inspection we imposed conditions on the provider's registration. At this inspection we found enough improvement had been made to remove these. We will continue to monitor the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was ‘Inadequate’ (published 15 December 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.