Bertie & Bells Ltd

Updated 21 November 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.

The inspection took place on 5 and 8 October 2018 and was announced. The provider was given 48 hours’ notice as they provide a domiciliary care service. We wanted to ensure that people were expecting our calls and were available to speak with us. The inspection team consisted of one inspector and two assistant inspectors.

The service was registered in October 2017 and this was the first comprehensive inspection. Before the inspection we looked at information we held about the service. We looked at notifications that the provider had submitted. A notification is information about changes, events and incidents which the provider is required to tell us about by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to decide which areas to focus on during our inspection.

During our inspection we spoke with five people, four relatives, four members of staff, the care manager and the registered manager, who is also the provider. We reviewed a range of records about people’s care and how the service was managed. These included the individual care records for five people, medicine administration records (MAR), four staff records, quality assurance audits, incident reports and records relating to the management of the service.

Updated 21 November 2018

The inspection took place on 5 and 8 October 2018 and was announced. The provider was given 48 hours’ notice as the service provides a domiciliary care service. We wanted to ensure that people were expecting our calls and were available to speak with us.

Bertie & Bells Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. It can provide a service to older people, those living with dementia, people who have a learning or physical disability and people who have mental health needs. Not everyone using the service received the regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, which includes help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection there were 53 people who used the service, 32 of whom received the regulated activity of personal care.

Most people funded their own care although one person had their care publicly-funded. The service was registered in October 2017 and is the only service owned by the provider, who was also the registered manager. A registered manager is a ‘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 home is run.

People were asked their consent for day-to-day decisions that affected their lives. However, people were not always supported to have maximum choice and control of their lives. Staff did not support them in the least restrictive way possible. The policies and systems at the service did not always support this practice. This was an area of practice in need of improvement.

People told us that they received a service that made a difference to their lives. Positive relationships had developed between people and staff. Staff took time to get to know people and their preferences. People and their relatives told us that staff were consistently kind, caring and compassionate. One person told us, “They are lovely people, they do anything I want and they are so caring”. Another person told us, “We always have a chat. They are so interested in my family. They’re more like friends than carers. They are very caring”.

People were involved in their care. They were treated with respect and their dignity and privacy was maintained. Staff were introduced to people prior to offering support and people told us that this made them feel comfortable as they knew who to expect once their visits began. People were supported to maintain their skills and independence. Staff supported people to go to the shops, local cafes and the bank.

Care was person-centred and tailored to people’s needs. People and relatives told us about a service that was responsive and adapted to changes in their needs and requirements. Efforts had been made to gather information about people’s backgrounds, their hobbies and interests to provide staff with an insight into people’s lives before they started to use the service. People were supported to maintain their interests and have contact with family and friends.

People told us that they would feel comfortable to raise issues or concerns and that the management team and staff were friendly and approachable. People, their relatives and staff were complimentary about the leadership and management of the service. A relative told us, “They honestly truly do care for their customers. They go the extra-mile and they do a superlative job monitoring my relative. They are obviously caring people, they are doing the job how it should be done. I had contacted a number of companies when I was looking for a care service for my relative. This was the only company that continually focussed on my relative. I knew what I wanted, but they kept going back to focussing on my relative”. Another relative commented, ‘Bertie & Bells is so on the ball and just knocks it out of the park’.

Clear aims and objectives drove the management team and staff to provide a good-quality service. Quality assurance processes ensured that people received the quality of service they had a right to expect. People, their relatives and staff told us that they were involved in decisions that affected people’s care and the running of the service. That their suggestions and feedback were welcomed and listened to.

People told us that they felt safe due to the support that they received from staff. One person told us, “I fell in the bathroom once and was found unconscious, they called the paramedics. Another time, they found me unconscious against a wall and they had to ring the paramedics. I trust myself with them completely”. Staff had a good understanding of how to support people safely and knew what to do if they had concerns about people’s safety. There was a reflective approach to providing care and the management team and staff learned from situations to ensure that care continually improved.

People were supported to live healthy lives. People were supported to have their medicines safety and on time. Staff were responsive when people were unwell. There was good partnership working with external healthcare professionals to ensure best practice and maintain a coordinated approach to people’s care.

People were protected from the risk of infection and cross-contamination. Risks to people’s safety were assessed and minimised.

People and their relatives felt that staff had appropriate skills and were competent. One person told us, “Yes, they know what they’re doing”. Staff had a good understanding of the people that they supported. People told us that they received care from consistent staff who knew them and their needs well.

As part of some people’s care packages, they were supported to have sufficient quantities to eat and drink. Staff promoted people’s independence when offering support. People were involved in shopping for items of their choice.