Brunelcare Domiciliary Care Services Bristol & South Gloucestershire

About the service

Brunelcare Domiciliary Care Services Bristol & South Gloucestershire is a domiciliary care agency. It provides support to people who live in their own homes. At the time of the inspection, the service was providing support to 104 people.

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

People felt safe with the staff who supported them, and many had built positive relationships. Staff understood their responsibilities and received regular training to ensure people were kept safe. Where risks were identified, action was taken to safeguard people appropriately.

Systems and processes were in place to protect people from the risk of harm or abuse.

Although there had been a high number of errors in the recording of medicines administration, these had been well managed and did not usually present any risk to people. Regular checks were carried out and action had been taken to monitor themes and improve practice. The number of errors had reduced, and the manager was keen to improve standards further in this area.

People received an individualised service from a well-led team of staff. The manager had only been in post for a few months at the time of our inspection, but they had made changes and received positive feedback from people and staff.

Standards and performance were monitored, and improvements made where necessary. Audits and checks were consistently carried out and these supported all staff to provide high quality care and support.

Staff reflected the vision of the organisation in the support they provided. All the staff we spoke with were committed to providing high quality support which enabled people to stay in their own homes.

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.

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 (12 October 2018).

Why we inspected

We undertook this targeted inspection to check on specific concerns we had about safeguarding and management. We found no evidence during this inspection that people were at risk of harm.

CQC have introduced targeted inspections to check specific concerns. These inspections do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question. The overall rating for the service remains good.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager in post and they were available when this inspection took place. 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 last inspection of the service was completed in February 2016 and we rated the service overall as Good. There were no breaches of the regulations.

In April 2018 the service became one of four preferred domiciliary care providers for South Gloucestershire Council. The geographical area covered by this service include Kingswood, Downend, Emersons Green, Pucklechurch, Wick, Marshfield, Hanham, Longwell Green, Cadbury Heath, Oldland Common and Barrs Court. The service has two functions. To provide a six-week reablement service to help people regain as much independence as possible and a long-term community care service.

People were safe. Staff completed safeguarding adults and moving and handling training to ensure they maintained people’s safety. Risk assessments were completed as part of the care planning process. Where risks were identified there were plans in place to reduce or eliminate the risk. Safe staff recruitment procedures were followed to ensure people were not looked after by unsuitable staff. There was a staff recruitment drive in place to ensure there were sufficient numbers of staff to fulfil their commitments and in the meantime care calls were sub-contracted to agency workers. Medicines were managed safely.

The service was effective. Staff received training to enable them to carry out their jobs well. New staff completed an induction training programme at the start of their employment and any new-to-care staff completed the Care Certificate. There was a mandatory training programme for all staff to complete to ensure they had the necessary skills and knowledge to care for people correctly.

People’s care and support needs were assessed and a support plan devised detailing how the service would support them. For those people who were supported by the reablement team, their goals were identified and their care plan set out how the staff would help them regain as much independence as possible. People were provided with assistance to eat and drink well where this had been identified as a care need. The staff, particularly the reablement workers, worked with other health and social care professionals to ensure people’s health and wellbeing was maintained.

People were encouraged to be as independent as possible and were involved in making decisions and making their own choices about their care and support. People were asked to consent before care and support was delivered. The service was meeting the requirements of the Mental Capacity Act 2005.

The service was caring. People were treated with kindness and were listened to. The service had come through a period of upheaval and people had not liked the lack of continuity with the staff who covered their care calls. There was an acknowledgement that things were settling down and the staff were now able to form good working relationships with the people they were looking after.

The service was responsive. Care plans and the service delivery arrangements were reviewed after six weeks and then annually or more often if needed. Care arrangments were amended as required. People were provided with information about the service and details about how to raise any concerns they may have. People were encouraged to provide feedback about the service they received and action was taken where necessary.

The service was well led. The staff team was led by a registered manager. The two staff teams were provided with good leadership and management. Staff meetings ensured they were kept up to date with changes and developments in the service. There was a regular programme of audits in place, which ensured that the quality and safety of the service was monitored.

Brunelcare Domiciliary Care Services Bristol & South Gloucestershire provides personal care to adults in their own homes. At the time of our inspection around 200 people were using the service. Within the service, two distinct service types were provided. One was a reablement service that aimed to provide care for up to six weeks with the aim of assisting people to become more independent. This service was often provided at short (24 or 48 hours) notice, to people leaving hospital or in other circumstances where care was needed quickly. The second as a longer term domiciliary care service providing personal care for as long as people wanted or needed. Some people who used the reablement service moved to the longer term service. Some people who used the reablement service either did not need any further care, or moved to another domiciliary care provider.

There was a registered manager at the service. 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.

People received a service that was safe. People received care and support from staff they felt safe with. People were safe because staff understood their role and responsibilities to keep them safe from harm. Risks were assessed and individual plans put in place to protect people from harm. There were enough skilled and experienced care staff to meet people’s needs. The provider carried out employment checks on care staff before they worked with people to assess their suitability. Medicines were well managed with people receiving the assistance needed.

The service provided was effective. Staff had been trained to meet people’s needs. Staff received supervision and appraisal aimed at improving the care and support they provided. People were supported to maintain their independence. Staff understood their roles and responsibilities in supporting people to make their own choices and decisions.

People received a service that was caring. Care staff took time to listen and talk to people. People were treated with dignity and respect. People were involved in planning the care and support they received. Staff protected people’s confidentiality and need for privacy. Equality and diversity was seen as important by staff and action taken to ensure people’s needs were met. People told us staff went the ‘extra mile’ to help.

The service was responsive to people’s needs. Staff providing care and support were familiar to people and knew them well. The provider encouraged people to provide feedback on the service received. The service made changes in response to people’s views and opinions.

The service was well-led. The registered manager and other senior staff provided good leadership and management. The vision and values of each of the two parts of the service were communicated and understood by staff, people using the service and their family and friends. Staff understood their roles and responsibilities. The quality of service people received was continually monitored and any areas needing improvement identified and addressed.

We found evidence there were enough qualified, skilled and experienced staff to meet people's needs. We spoke with staff during the inspection who confirmed that staffing levels were good at the agency. They told us "We seem well-staffed in my team and try and help cover any shortfalls amongst ourselves' and 'We have enough staff to cover the call runs to provide a good service'.

We spoke with two staff who told us 'I haven't worked for the agency for that long but found the recruitment process was very thorough' and 'I was not able to start until my checks were completed'.

Peoples' personal care records including medical and personal records were accurate and fit for purpose. People were provided with individual detailed care plan files that were person centred. The records contained information about people's health and well-being and how they liked to be cared for this included support plans and routines people liked to follow.

People told us what they thought about the service they received from the staff who visited them in their own homes. Examples of comments people made included, 'the staff are very, very good, they are all caring give them a gold star', 'I think the carers are very good', 'they are all so kind', 'they do what I ask', and 'I am very, very happy with the service and I appreciate it very much'.

Peoples' care plans were informative and up to date and they clearly showed how the staff assisted them with their personal care needs.

People were assisted by staff who understood their role in keeping them safe from the risk of abuse. The agency had systems in place to safeguard people from abuse.

People were supported by staff who had been on a range of training to assist them with their care. Staff were being supervised in their work, so that they provided effective care for people who used the service

People were assisted to make complaints about the agency. When people made complaints they were properly investigated.