Background to this inspection
Updated
19 December 2018
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.’
This was a comprehensive inspection. The inspection was carried out by one inspector and one 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.
This inspection took place on 27 November 2018 and was announced. We gave the service 24 hours' notice of the inspection visit because the location provides a domiciliary care service and we needed to be sure management would be available to talk with us.
Inspection activity included visiting the office location to see the registered manager and office staff; and to review care records, policies and procedures and quality assurance documents. We carried out telephone interviews with people who used the service, their relatives and staff.
Before the inspection, we reviewed all the information we held about the service including previous
inspection reports and notifications received by the CQC. A notification is information about important events which the service is required to tell us about by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to decide which areas to focus on during our inspection. We requested and received feedback on the service from the local safeguarding teams and commissioners.
We spoke with nine people using the service and six relatives of people using the service. We spoke with nine staff; this included the registered manager, care manager, office administrator and care workers. We looked at records for three people using the service including support plans and risk assessments. We analysed three medicine administration records. We reviewed training, recruitment and supervision records for three staff including competencies and recent observations of their competencies. We looked at minutes of team meetings, various policies and procedures and reviewed the quality assurance and monitoring systems of the service.
Updated
19 December 2018
This announced inspection took place on 27 November 2018. We gave 24 hours' notice of our intention to visit the provider’s office to make sure people we needed to speak with were available. At the time of our inspection 68 people were receiving support from the service.
Bespoke Care & Support Services is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults living in the Huddersfield area. Everyone using Bespoke Care & Support Services was in receipt of the regulated activity of 'personal care’; help with tasks related to personal hygiene and eating. Where relevant, we also take into account any wider social care provided.
Bespoke Care & Support Services was last inspected on 9 September 2017. At that time, it was rated requires improvement overall and was in breach of regulations in relation to staff's access to training and supervision and good governance. At this inspection, we found improvements had been made in these areas and the provider was no longer in breach of regulations.
On the day of our inspection a registered manager was in place. 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.
The provider’s compliance with the Mental Capacity Act 2005 (MCA) was inconsistent. The registered manager had a good understanding of how to support people who required best interest decisions made on their behalf however the record keeping and staff’s understanding around this area required improvement. We recommended the provider researches and implements best practice guidance to ensure specific decisions made in people's best interest are appropriately recorded.
Staff had completed safeguarding adults training and knew how to keep people safe and report concerns. People's medicines were safely managed.
People told us they felt safe due to the support they received from staff. Staff had a good understanding of how to support people safely and knew what to do if they had concerns about
people's safety.
Staff were recruited safely. There were enough staff to provide people with the care and support they needed.
People and their relatives felt staff had appropriate skills and were competent. Staff had a good understanding of the people they supported and had access to ongoing training and supervision to support and improve their practice.
People told us they received a service that made a difference to their lives. Positive relationships had developed between people and staff. People and their relatives told us staff were consistently kind, caring and compassionate.
People were supported to have a balanced diet that met their individual dietary needs. They were supported to access healthcare services to maintain their health.
People were involved in their care. They were treated with respect and their dignity and privacy was maintained.
People’s needs in relation to the protected characteristics under the Equalities Act 2010, were considered in the planning of their care. People's communication needs were assessed
People told us they would feel comfortable to raise issues or concerns and that the management team and staff were friendly and approachable. The registered manager appropriately investigated complaints and incidents
People, their relatives and staff were complimentary about the leadership and management of the service. There were several systems in place to monitor the quality of care.