Archived: The Care Bureau Ltd - Domiciliary Care - Rugby

The service delivers personal care to people in their own homes. At the time of our inspection, 162 people were receiving the service.

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. On the day of the inspection visit, the provider’s compliance manager supported the registered manager to explain how the service operated and was managed.

People told us they felt safe with the staff that came to their home. Staff were trained in safeguarding and understood the signs of abuse and their responsibilities to keep people safe. The provider’s policies for keeping people safe included pre-employment checks, to make sure staff were suitable to deliver care in people’s own homes.

Risks to people’s health and wellbeing were identified at the initial assessment of care and their care plans included the actions staff should take to minimise the risks. Staff understood people’s needs and abilities because they read their care plans and shadowed experienced staff, so they could get to know people well before working with them independently.

The manager assessed risks in each person’s home, so staff knew the actions they should take to minimise the risks. All staff were trained in medicines management, to ensure they knew how to support people to take their medicines and to keep accurate records.

Staff received the training and support they needed to meet people’s needs effectively. Staff had regular opportunities to reflect on their practice, to attend training in subjects that interested them and to consider their personal development.

The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People made their own decisions about their care and support. Staff understood they could only care for and support people who consented to receive care from them.

People were supported to eat meals of their choice and staff understood the importance of people having sufficient to drink. Staff referred people to healthcare professionals for advice and support when their health needs changed.

Staff had regular care calls so they got to know people well. People told us staff were kind and respected their privacy, dignity and independence. Care staff were thoughtful and recognised and respected people’s cultural values and preferences.

People were confident any complaints would be listened to and action taken to resolve them. When people raised issues, the registered manager resolved them immediately, through face-to-face meetings with people.

The provider’s quality monitoring system included asking people for their views about the quality of the service through telephone conversations, visits by a supervisor and regular questionnaires.

The manager checked people received the care they needed by monitoring the time staff arrived for scheduled calls, reviewing care plans and daily records, and through feedback from supervisors.

.

The summary below describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report. We used the evidence we collected during our inspection to answer five questions.

Is the service safe?

We found people's needs had been assessed and individual care plans drawn up to meet people's needs. Risk assessments were in place to keep people safe. The provider carried out planed observations of staff and undertook unannounced spot checks to ensure risk assessments and care plans were followed by staff.

Arrangements were in place to deal with foreseeable emergencies. We were told by staff members we spoke with that they were able to contact a supervisor or the registered manager when needed.

A copy of the local Safeguarding policy and procedure was in place and available to staff. We looked at staff training records and saw staff had received training on keeping people safe. Staff we spoke with were able to tell us what they would do in the event of abuse being witnessed, suspected or alleged.

The provider carried out recruitment checks before staff started work to ensure they were suitable to provide care and support to vulnerable people. There were enough staff to meet the needs of the people cared for by The Care Bureau.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. One person told us, "The staff make sure I'm well cared for". A relative told us, 'We are pleased and the service works well'.

We found staff received training to meet the needs of people. Staff we spoke with were knowledgeable concerning the needs of people they cared for.

Is the service caring?

We found the provider had systems in place to ensure people's consent was obtained before care and support was provided. We saw people had been involved in agreeing to the levels of care and support they needed. We spoke with people who told us they had agreed how they would be cared for.

Staff we spoke with told us they felt people's needs were met in a caring and considerate way. One staff member said, "We try to make sure people are happy with the care they receive." A relative we spoke with said, "My relative is happy with the staff, they seem genuinely caring".

Is the service responsive?

We found the provider had listened to people's views and made changes to the service provided as a result. The provider had changed the times and amount of care and support provided as people's needs changed.

People using the service and relatives told us they felt the provider responded to issues they raised regarding the care and support provided. A relative told us, "They have dealt with things I brought up".

Is the service well-led?

Staff we spoke with told us they had received training to provide care and support to people. We looked at staff training records and saw that training was planned and provided. The provider ensured staff were supervised regularly.

We found the provider monitored the health and safety of people using the service, staff and others. We were told by care staff that the health and safety of people who used the service was seen as a priority by the provider. Care staff also said their health and safety was monitored by care supervisors and the registered manager.

People we spoke with told us that the manager assessed their needs and abilities at a meeting. In the three care plans we looked at, we saw the instructions for staff minimised risks to people's health and well-being. One person told us, 'I definitely get the care and support I need.'

In the three care staff files we looked at we saw that the manager checked that staff were suitable to work with vulnerable people before they started working for the service. Care staff told us they had training in safeguarding people from abuse. One care staff told us, 'When I raised concerns, they were followed up and reported appropriately.'

Care staff told us they felt supported to work effectively. We found the manager planned regular one to one meetings with staff, to make sure they had the opportunity to talk about their work. One member of care staff told us, 'I have supervisions, but I like to just come in and talk with the manager.'

The manager's quality assurance system included making sure that staff received up to date training and observing staff in practice. The manager telephoned people at home, to check that they were happy with the service. One person told us, 'I am very impressed with the care. I have no complaints whatsoever.'