West Bromwich African Caribbean Resource Centre

West Bromwich African Caribbean Resource Centre is a domiciliary care service which is registered to provide personal care to people living in their own homes within the community. At the time of our inspection 65 people received care and support from the service.

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

People told us they felt safe. Staff informed us of the signs of abuse and the reporting processes they should follow if they had concerns. People's risks were assessed, and staff had a good understanding of how to minimise them. The provider’s on-going recruitment process ensured there were suitable staff to support people safely. People received their medication as prescribed. Staff followed infection control guidance and had access to personal protective equipment.

People were supported by staff who had the skills and knowledge to meet their needs. People were supported to have choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests. People were given choices and their consent was gained before providing support. Staff knew of people’s dietary needs. People had access to healthcare professionals when required.

People were supported by kind and caring staff who knew them well. People's privacy and dignity was maintained. Staff knew it was important to encourage people to maintain their independence.

Assessment and reviews of people’s care and support needs were undertaken regularly or more frequently when it was required. People and /or their relatives were included in these processes to ensure all needs were determined and addressed. People and their relatives knew how to raise concerns and would feel comfortable to do so.

A range of improvements had been implemented since our last inspection. Quality assurance systems including spot checks had been used to identify what aspects of the service worked well and where improvements may be needed. Provider feedback surveys had been used to gather information about the views of people and relatives about the service provision. People, relatives and staff spoke positively of the registered manager.

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 06 July 2017).

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 re-inspection programme. If we receive any concerning information we may inspect sooner.

West Bromwich African Caribbean Resource Centre are registered to deliver personal care. They provide domiciliary care to children and younger and older adults living in their own homes. At the time of our inspection 65 people were receiving personal care from the provider.

At our last inspection in April 2015 the provider was meeting all the regulations but we identified that some areas in the key question of well-led did not demonstrate effective governance. On this our most recent inspection we found that the specific areas identified as requiring improvement had been addressed.

The service had a registered manager. 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 were comfortable with the care staff supporting them and felt safe in their care. Care staff knew how to report any concerns they may have about poor or unsafe practices. Risk assessments were completed and care staff knew how to assist people safely. The provider recruited care staff that were of the correct character to carry out care work. Care staff arrived on time, stayed with people for the correct length of time and were reliable. Care staff were appropriately trained in how to support people with their medicines.

Care staff had the skills and knowledge to meet people needs effectively. The provider ensured all care staff received a good level of supervision and training, along with a full induction to ensure they were competent to work with people more independently. Care staff were able to describe how they supported people in line with the principles of the Mental Capacity Act 2005. Information about people's dietary intake was routinely recorded, allowing people's nutritional health to be monitored. Care staff supported people to maintain good health.

People were supported by care staff that took time to get to know them in order to provide the care they needed in the way they wanted it. People were receiving the support they required from care staff who had built positive relationships with them. Care staff supported people to make their own day to day care decisions. People’s privacy and dignity was respected by the care staff supporting them. Records in relation to the support people needed highlighted their abilities, the importance of maintaining their independence by detailing the level of support they needed.

People had time spent with them before they starting using the service, asking them what they needed support with and how they wanted this help to be provided. The provider had effective systems in place to regularly review people’s care provision, with their involvement. Peoples care was personalised to them and care plans contained information about the person, their needs, lifestyle choices and cultural needs. Care staff knew people’s individual needs. People were provided with information about how to make a complaint, including being provided with a blank complaints form on joining the service.

The provider had acted to improve the level of communication and inclusion of the registered manager in relation to the on-going management and future planning of the service. The provider’s resources in place to monitor the safety and quality of the service were proving insufficient in relation to their recent expansion of the service. People were happy with the standard of care that they received and care staff were well supported by the management team. The registered manager had the knowledge and skills to develop care staff, deliver the service and was keen to continuously improve. Care staff were complimentary about the registered manager’s leadership skills and management style. The provider gave people the opportunity to give feedback about the service through surveys and regular reviews of their care by phone or face to face.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

Four out of the five people we spoke with told us they felt safe. Safeguarding procedures were in place and the three members of staff we spoke with understood how to safeguard people they supported.

We found that policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards were in place. At the time of our inspection no applications had needed to be made. This meant that people would be safeguarded as required.

After the inspection we received information that a safeguarding concern had not been reported to the local authority. We found that this was because there was insufficient management cover in place when the registered manager was on leave. The registered manager told us they would address this matter.

All of the five people we spoke with told us that they felt their rights and dignity were respected.

Systems were in place to make sure that the registered manager and staff learn from events such as accidents and incidents and complaints. This reduces the risks to people and helps the service to continually improve.

Risk management plans were up-to-date and staff said they received updates when people's needs changed. People were not put at unnecessary risk. People were supported to make choices and remained in control of decisions about their care and lives.

We found that recruitment practice was safe and thorough. We were shown details of one staff member, who had been subject to disciplinary action, which was dealt with appropriately. We saw that the service had taken necessary action with respect to staff to ensure the safety of people who used the service. Policies and procedures were in place to make sure staff had information they needed so that unsafe practice was identified and people were protected.

Is the service effective?

People's health and care needs were assessed with them and their families where required. People were involved in making decisions about their plans of care. We saw that specialist dietary needs had been identified and met where required. All of the people said that their care plans were up to date and reflected their current needs. All of the people we spoke with told us they were involved in planning their care.

The registered manager told us about one person who they helped to find a suitable advocate. People could be supported by an advocate if needed.

Is the service caring?

We spoke with five people who used the service and three relatives. We asked them for their opinions about the staff that supported them. Feedback from people was largely positive, for example; 'The carers are golden. They do everything I need them to do' and: 'I used to get different workers. I have permanent carers at the moment. I am very satisfied with them'.

People who used the service, their relatives, friends and other professionals involved with the service took part in a telephone based monitoring review. One relative we spoke with said they had recently received a survey to complete about the service. We saw that where shortfalls or concerns were raised these were dealt with.

People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People knew how to make a complaint if they were unhappy. One person said that they had made a complaint and were satisfied with the outcome. We looked at examples of investigations which had been completed in line with the complaints policy. We saw that complaints are investigated and action taken as necessary.

The registered manager completed the staff rotas, they told us and we saw they took people's care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people's needs are always met.

The service worked well with other healthcare professionals and external agencies to make sure people received care in a coherent way. We found that the provider had not worked in a co-ordinated way with other external safeguarding agencies when a safeguarding allegation was recently reported to them.

Is the service well-led?

The service had a quality assurance system, and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

We found that the registered manager did not have direct access to the human resources database to advise us on the outcome of a recent staff investigation. We received this information after the inspection when the registered manager had requested this from the chief executive.

We found that the registered manager's working hours had recently been reduced and they were only working four days per week. We found that adequate management cover arrangements were not in place when the registered manager was on leave or not at work, for the purposes of carrying out the regulated activity.