Background to this inspection
Updated
9 July 2019
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 Care Act 2014.
Inspection team
This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that there would be a member of staff in the office to support the inspection.
Inspection activity started on 12 June 2019 and ended on 26 June 2019. We visited the office location on 12 and 18 June 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with 14 people who used the service and six relatives about their experience of the care provided. We spoke with six members of staff and the registered manager, business and finance manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included six people’s care records and multiple medicines administration records. We looked at six staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and quality assurance records were reviewed.
After the inspection
We contacted the local authority and Healthwatch for feedback about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also contacted 10 healthcare professionals for their feedback about the service.
Updated
9 July 2019
About the service
Butterfly Home Help (Bath and Wiltshire) is a domiciliary care service that provides personal care to people living 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.
People’s experience of using this service and what we found
People were supported to manage their medicines safely, guidance on support people needed with their medicines was recorded in care plans.
People were being supported by sufficient numbers of staff, there had been no missed visits. Risks had been identified and assessed, staff reviewed risk management plans regularly. People were being supported by staff who had received training in safeguarding and understood how to report any concerns.
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. People were supported by staff who were trained and supported by the service. People’s needs were assessed and where needed, support was provided to access health services.
People were being supported by staff who were kind and caring. People were happy with their care workers and talked about them fondly. One person told us, “Staff are all very helpful, professional, very kind, sociable and really lovely.” One relative told us, “The staff that we get here are first class really caring. They are friends, not just carers and they have the right attitude.” People’s dignity was promoted and maintained, and their independence promoted.
People had individual plans of care that were updated regularly. The service aimed to provide people with a core group of workers so that they received a consistent service. People told us staff did not rush their care and had time to sit and chat. People had support to record their wishes for end of life if they wanted to. The service liaised with healthcare professionals for support to provide palliative care.
People received their care and support from an open and inclusive service. Staff told us they enjoyed their jobs and felt valued. People, relatives and staff told us the service was well-managed. People and their relatives knew how to complain, and we saw complaints were logged and investigated.
Quality monitoring systems were in place which identified improvement and the provider was striving to continuously improve and develop the service. Partnership working was evident with good relationships being formed with the local community and healthcare professionals. One professional told us, "Butterfly are one of the best agencies I have ever worked with."
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update - The last rating for this service was Requires Improvement (Report published 13 June 2018) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our inspection schedule. If we receive any concerning information we may inspect sooner.