Blossom Care For You LTD

Blossom Care for You LTD is a domiciliary care agency. The service provides personal care to people in their own homes. At the time of our inspection there were 59 people using the service.

Not everyone who used the service received personal care. In this service, the Care Quality Commission (CQC) can only inspect the service received by people who get support with personal care. This includes help with tasks related to personal hygiene and eating. Where people receive such support, we also consider any wider social care provided.

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

People’s feedback was very positive. One person said, “I am very happy. The carers look after me well.” A relative said, "The last few months have been nine out of 10. On the right track!"

We found improvements had been made since our last inspection. The provider was now meeting the fundamental standards of care as defined in the regulations.

There had been no registered manager at Blossom Care for You LTD for 12 months. We found further improvements were still needed in how the provider audited the quality of service, and how the provider planned to keep the service going in the event of an emergency.

We have made a recommendation about the provider's business continuity plan.

The provider had made improvements in how risks to people’s safety and wellbeing were managed, how people's medicines were administered, and how they responded when things went wrong. There were enough staff to support people safely. Processes were in place to protect people against the risks of abuse and infectious disease.

People received care and support that was effective, based on detailed assessments and care plans, and delivered by staff with the necessary skills and training. 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 information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the CQC website at www.cqc.org.uk.

Rating at last inspection and update

The last rating for this service was requires improvement (published 25 September 2019).

At our last inspection we found breaches of the regulations in relation to:

- the provider’s failure to do all that was reasonable to reduce risks to people’s safety,

- the provider’s failure to have effective systems to monitor the quality of care people received, and

- the provider’s failure to make sure they acted in people’s best interests where they lacked capacity to make certain decisions.

After the last inspection, we issued warning notices requiring the provider to comply with the first two regulations by 15 October 2019. The provider sent us a plan of action to tell us what they would do and by when to improve with respect to the third breach.

At this inspection we found improvements had been made and the provider was now meeting these regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 21 June 2019. We found breaches of three regulations as described above.

We undertook this focused inspection to check if the provider had made improvements and if they were now meeting the legal requirements. This report only covers our findings in relation to the key questions safe, effective and well-led.

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 requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Blossom Care for You LTD on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Blossom Care for You Ltd is a domiciliary care service which provides support and personal care to people in their own homes.

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.

At the time of the inspection there were 49 people receiving support with personal care.

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

Risk assessment and support plans were not detailed enough to ensure people were safe from avoidable harm. People’s risks were not fully assessed to identify any key actions required to keep people safe, such as when people were at risk of developing a pressure ulcer or risk of falling. This put people at increased risk of harm.

When needed, people’s capacity to consent was not assessed. As a result, we could not be assured people were always 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 did not support this practice.

Systems in place to review the quality of care and ensure records were complete and accurate were not sufficient. Audits did not identify issues highlighted in this inspection report and actions from audits and incidents were unclear to ensure shortfalls in the service would be addressed promptly.

People and their relatives told us that staff were kind, compassionate and caring. People felt that staff would support them with all of their needs and were flexible in the way they worked. They felt involved and kept up to date with all elements of their care. People and their loved one’s fed back positively about the registered manager and the staff team.

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 requires improvement (published 16 May 2018). Since this rating was awarded the provider has altered its legal entity. We have used the previous rating and enforcement action taken to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was the first planned inspection since the service registered under the new legal entity.

Enforcement

We have identified breaches of regulations on this inspection. This related to; safe care and treatment, as people’s risks were not fully assessed; consent, as people’s capacity to consent to care and treatment was not assessed; and good governance, as records were not accurate and up to date, and measures in place to monitor the quality and safety of the service were not sufficient.

Please see the action we have told the provider to take at the end of this report.

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 request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.