The Care Bureau Ltd - Domiciliary Care - Northampton

Updated 10 February 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was undertaken by 2 inspectors

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 24 November 2022 and ended on 6 December 2022. We visited the location’s office 24 November 2022.

What we did before the inspection

We reviewed information we had received about the service including feedback we had received from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people who used the service and 4 relatives of people using the service about their experience of the care provided. We spoke with 10 members of staff including 6 care staff, a scheduler, a supervisor, quality and compliance manager and the registered manager.

We reviewed a range of records. This included 7 people’s care records and multiple medication records. We looked at staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 10 February 2023

About the service

The Care Bureau Ltd– Domiciliary Care- Northampton is a domiciliary care service providing care to people living in their own homes in Northampton. At the time of our inspection, 101 people were using the service. 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.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support:

Risks to people’s care had been identified but there was not always enough information for staff to know how to mitigate the risk. Care records lacked detail about people’s health needs.

People were cared for by staff who knew them, however at times they did not know which care staff would be visiting and the times and length of care calls varied.

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. Staff understood the need to seek consent from people before they provided care or completed tasks for people.

Staff were trained and had a good understanding of people’s needs. They supported people, when needed, to access other health professionals. Their competency was tested in relation to medicine administration.

Right Care:

People’s care was not always person-centred. At weekends the scheduling of people’s calls was not always at the time when people wanted. At times staff were stretched to provide the full support people needed.

People felt safe with staff and said most staff knew how to support them. Staff were recruited safely and knew how to protect people from harm or abuse.

Care plans demonstrated people's equality characteristics were considered and respected.

Right Culture

Improvements were needed to the system in place to monitor the quality and performance of the service.

Care records were reviewed but audits had not identified gaps in information and the information was not always up to date.

People and relatives had mixed views in relation to communication with the service and whether they were asked for feedback. Staff were supported but did not always feel they were listened to. The registered manager shared evidence of feedback they had sought.

The registered manager was open and transparent and implemented changes based on the feedback given.

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 (published 12 July 2019)

Why we inspected

We received concerns in relation to management of care calls, poor hygiene practices and lack of oversight. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Care Bureau Ltd – Domiciliary Care- Northampton on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to governance and oversight of the service.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.