Archived: Beech Tree Total Care

Updated 28 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 28 October 2016 and was announced. The provider was given 48 hours’ notice because the service is a domiciliary care agency and we needed to be sure that staff would be available on the day of the inspection. This was our first inspection of this service.

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. The expert had experience of caring for older people who use services such as this one.

Before the inspection, we reviewed the completed Provider Information Return (PIR) which the provider had sent to us. The PIR is a form that asks the provider to give some key information about the service such as, what the service does well and improvements they plan to make. We also reviewed information we held about the service including notifications. A notification is information about important events which the provider is required to send us by law.

During the inspection we spoke with six people who used the service. We also spoke with four relatives of people who used the service, four care staff, one care coordinator, the trainer, the office manager, the provider’s chief executive officer (CEO) and the registered manager. We reviewed the care records, risk assessments and medicines administration records of seven people who used the service, and we looked at the recruitment and training records for four members of staff. We also reviewed information on how the quality of the service, including the handling of complaints, was monitored and managed.

Updated 28 January 2017

The inspection took place on 28 October 2016 and was announced. We gave the service 48 hours notice of our inspection because we needed to make sure there was someone available at the provider’s offices. This was our first inspection of this service.

Beech Tree Total Care provides personal care and support to people in their own homes. There were 96 people using the service at the time of our inspection.

The service has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 did not always know who the registered manager was but found that there was always a member of staff they could speak with at the office if they needed to.

The provider’s quality assurance systems did not always capture and address all areas that required improvement within the service. The people who used the service and their relatives were able to contribute to the development of the service by way of satisfaction surveys. Six monthly staff meetings were also held as a way of involving staff in the development of the service.

Staff were trained in safeguarding people and they knew how to keep people safe. People had care plans in place but they were inconsistent and there was one care plan for 2 people which was not reflective of person-centred care. People had risk assessments that gave guidance to staff on managing risks that people were exposed to. There were enough staff to provide care to people who used the service and we found that there was only one missed care visit in an eight weeks period. However, the deployment of staff meant that the travel time allocated to staff from one care visit to the next was not always adequate. Consequently people experienced rushed or late care delivery and calls that were shorter than they should have been.

Staff were trained and understood their responsibilities under the Mental Capacity Act 2005. They were respectful of people, their dignity and privacy, and they made sure they sought people’s consent before they provided care. Where necessary, staff supported people with their nutritional needs and to have access to healthcare services. Staff were supported in their roles by way of supervision and appraisals of their performance.

People and their relatives found staff to be kind, caring and of good humour. Positive relationships had been developed by staff with the people who used the service and their relatives. Staff were knowledgeable about the people they cared for. There was an effective system in place for managing complaints.

During this inspection we identified that there were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to the safe care and treatment of people and person-centred care. You can see what action we told the provider to take at the back of the full version of the report.