We carried out a review of the data available to us about Betna Agencies Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Betna Agencies Ltd, you can give feedback on this 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.
Betna Care Agency Ltd is a domiciliary care service providing support for up to 27 people, the majority of whom receive personal care. The service provides care to people living in their own homes in Nottingham.
People’s experience of using this service and what we found
Staff pre-employment recruitment checks did not provide adequate assurances staff were suitable for their job role. Staff were not always trained or had their competence checked to ensure they had the skills to care for people. Staffing was not always sufficient to ensure people received safe care.
Risk assessments and care plans were not always in place. Equipment was not always used safely. Medicines management and administration did not always follow recommend guidance.
Staff did not have sufficient knowledge on identification of abuse and how to report safeguarding concerns. Systems to learn from when things had gone wrong were not in place.
Not all staff had access to policies and procedures, including for the management of Covid-19 and infection prevention and control. Audits of the quality and safety of services provided were not in effective operation. People’s views on the service were not used to inform improvements.
The registered manager had not communicated clear plans for the service to be managed in their absence. They had not displayed the CQC rating in their office or on their website as required. They had not submitted statutory notifications as required.
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 good. (Report published 23 October 2018)
Why we inspected
We completed this inspection due to concerns over recruitment practices.
This report only covers our findings in relation to the Key Questions Safe and Well-Led. 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 deteriorated to Inadequate. This is based on the findings at this inspection.
Enforcement
At this inspection we found a 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. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will continue to monitor information we receive about the service until we return to inspect as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The service has been registered with the CQC since 10 August 2017 and has provided regulated activity for people since October 2017. There was a registered manager in post at the time of our inspection. 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.
At the time of the inspection, four people received some element of support with their personal care. This is the service’s first inspection under its current registration.
People felt safe with staff and the risks to people’s safety had been assessed and acted on. Staff knew how to identify abuse and to protect people from avoidable harm. Staff arrived for each call on time and new staff to the service were safely recruited. People were supported safely with their medicines. Staff had received infection control training and the registered manager had the processes in place to investigate incidents and to learn from mistakes.
People’s care records did not always consider current legislation and best practice guidelines. People felt staff understood how to support them and staff felt well trained and supported by the registered manager. People received the support they needed with their meals. Transferable information was available should people require support or treatment from other healthcare agencies. 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.
People liked the staff and enjoyed their company. People were treated with dignity and respect and their privacy was respected. People were supported to contribute to decisions about their care and their independence was encouraged. The provider told us they would make information about how to contact an independent advocate more easily available for people. The provider had the processes in place to ensure people’s personal data was protected.
Before starting to receive care and support, assessments were carried out to ensure people’s needs could be met. People’s care plans were person centred and contained detailed information about their personal preferences. People’s diverse needs had been discussed with people. No formal complaints had been received but processes were in place to ensure they were responded to appropriately. End of life care was not currently provided; however, plans were in place to discuss this with people if they wished to.
People liked the registered manager and staff enjoyed working at the service. People were encouraged to give their views about how the service could be developed. The registered manager understood the requirements of their role and carried out their role in line with their registration with the CQC. Effective auditing processes were in place.